June 11 Healthwisc

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MHL

HEALTHWISC | JUNE 2011 FREE PUBLICATION

Est 1992

MODERN HEALTH AND LIVING

CHOOSING THE BEST BICYCLE FOR YOU Now you can choose the bicycle’s type, size, frame material, components and even color, ultimately choosing the best bike for you. (pg. 9)

GETTING ACTIVE WITH YOUR CHILD

BOOT UP FOR BOOT CAMP pain and rehab Senior Living Summer Retirement Feature

A GUIDE TO HEALTHY LIVING FOR MEN, WOMEN, CHILDREN AND SENIORS

MHL HEALTHWISC JUNE 2011

FOOT PAIN?

February 2011 Note

Change can absolutely be wonderful! This month I wanted to start things off with new and modern changes. Starting with the QR code. Get your cell phones out and scan the code on the front and enjoy our new updated website. If you don’t have the phone that scans, no problem, just go to www.modernhealthandliving.com as find even We’ve had some warm, sunny days this week and I took advantage more information about healthy living. of the warm weather by planting all my new carpet roses in my garden, I am very pleased that you’ve decided to join us this month. This is our BIG rollerblading around by neighborhood and grilling out with family and Health Awareness issue. We have packed so much up-to-date information into friends. I love the easy preparation of summertime foods and really these pages that this issue is just bursting with health! We have something for appreciate the fruits and vegetables that are available at this time. The men and women of all ages. We contact local health professionals every month flavors are incredible and they give me a lot of kitchen inspiration. I truly and are thankful that many have contributed to this issue. They are keenly feel healthier after increasing the amount of fresh veggies in my diet. I’ve aware of health concerns for this region (very important). We stay in touch been keeping up my daily juicing along with my vegetarian diet. with them so they can stay in touch with you. I think you’ll find something In this issue, I threw in an article about family activities. Now that here that can help you lead a healthier life. We hope that you share this special my son just graduated kindergarten, a summer activies plan was a must. issue with friends and family, too. Baseball, soccer camp, Tae Kwon Do and football is all on the list for both Speaking of family, I try to keep mine active throughout these cold months. my kids. Please try to keep your kids active this summer. My children are taking a Tae Kwon Do class 4 times a week. I encourage you We have lined up a lot of great health articles for you. We are very to try to find something to keep your children active and social. Wheather its interested in staying healthy and we know you are too. We have current gymnastics, dance, sport or just running around in circles, staying active keeps health information for you and those you love. Every month we talk to the body and mind healthy and developing. local health care professionals and we try to get that information to you. To us adults with Super Bowl Sunday and myself hosting the monthly You need to remember there are regional health issues and by contacting Bunco get together this equals food, food and even more food. It’s so important the health professionals here we can provide you with information that to keep ourself active, so it might be time to get that gym membership or start is pertinent to your health. We encourage you to contact us with your walking the malls again. Stay active!!! I hope you have a wonderful February suggestions so we can make MHL a better paper for you. Stay healthy! and will touch base again in March -Amanda Lewis AMANDA LEWIS | EDITOR

February 2011 EDITION

MHL

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HEALTHWISC | JUNE 2011 FREE PUBLICATION

Est 1992

MODERN HEALTH AND LIVING

Balance walking clinics and classes starting this Spring. CHOOSING THE BEST BICYCLE FOR YOU

www.footsolutions.com/milwaukee

WOMEN, CHILDREN AND SENIORS A GUIDE TO HEALTHY LIVING FOR MEN,

staff

contributers

contributers

pain and rehab Senior Living Summer Retirement Feature

Berkeley Wellness Letter, John Hopkins Medical Letter, Environmental Nutrition, Nutrition Action Health Letter, Columbia/St. Mary’s, Wheaton Fransician, Milwaukee Eye Care, Eye Care Specialists, Aurora, NorthShore Chiropractic, National Pedorthic Services, Lifesteps Wellness Clinic, Advance Physical Therapy, Elite Fitness and Racquet Club, Alexian Brothers Village, Transformations, NIH, Jensen Health and Energy, Foot Solutions, Allergy and Asthma Centers, Lake- shore Medical, The Ommani Center, Active Care Rehab, Interfaith Older Adult Services, Jewish Family Services, Laureate Group, Alzheimer Association, Tudor Oaks, Luther Haven, HealthWise Chiropractic, Greensquare Center for the Healing Arts, Midwest Audiology Integrative Family Wellness Center Social Security Offices and American Camp Association

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GETTING ACTIVE WITH YOUR CHILD

intendedistopublished replace the diagnosis of .your advise seeing a physician HealthWisc onknowledge the first oforeach month The doctor. articlesWe in this publication are in nowhenway ever a to health problem arises requiring an expert’sofcare. intended replace the knowledge or diagnosis your doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care. thanks

staff

size, frame maNow you can choose the bicycle’s type, choosing terial, components and even color, ultimately the best bike for you. (pg. 9)

Lewis Media Group Amanda Lewis Lewis Media Group Malberry Media Amanda Lewis Marlys Lewis Malberry Media Jerry Lewis Kornowski Marlys Marlys Metzger Jerry Kornowski BarryMetzger Lewis Marlys Barry Lewis

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JUNE 2011 EDITION

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WHAT’S SO GREAT ABOUT

Fiber?

The Johns Hopkins Medical Letter Dietary fiber may not be a miracle substance, but it’s close. People who eat enough fiber tend to be slimmer than their fiber-deficient counterparts and are less likely to develop several chronic diseases. In addition, adding more fiber to your diet is standard advice for a variety of digestive ills, from constipation to irritable bowel syndrome. Yet the typical American takes in only 40 percent of the recommended level, according to the 2010 federal dietary recommendations. Our number one source of dietary fiber is white flour, which accounts for about 16 percent of our daily intake. This doesn’t mean that white flour contains much fiber, because it doesn’t—it simply reflects how much of the refined stuff we eat. Read on for more about why—and how—we should get more fiber. The Facts about Fiber Fiber is a component of fruits, vegetables, grains, and legumes (a category that includes peas, beans, and lentils). Your body eliminates fiber without digesting it, and fiber contains no nutrients or calories. The two main types of fiber are soluble and insoluble; many foods contain a combination. Soluble fiber, which dissolves in water, is found in such foods as oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries, and apple pulp. After consumption, soluble fiber is fermented by bacteria in the colon, where it gets metabolized into byproducts called prebiotics that feed the bacteria in your gut, explains Gerard Mullin, M.D., an associate professor of medicine at Johns Hopkins University School of Medicine. These bacteria are necessary to keep the colon healthy. Insoluble fiber, which absorbs large amounts of water, adds bulk to the stool. This helps food pass more rapidly through the stomach and intestines, potentially relieving constipation. Good sources of insoluble fiber are whole-wheat breads, wheat cereals, wheat bran, cabbage, beets, carrots, Brussels sprouts, turnips, cauliflower, and apple skin. How much fiber should you be consuming? According to the Institute of Medicine, women over 50 need 21 grams (g) a day and men over 50 need 30 g. Dr. Mullin says a good diet has a mixture of both soluble and insoluble fiber, which means that if you need 1,600 calories a day, you should be eating about five servings of fruits and vegetables and six servings of grains—at least three of them whole grains—each day. Fiber and Your Heart The best evidence for fiber’s health benefits relates to heart disease. In fact, the U.S. Food and Drug Administration (FDA) allow the manufacturers of foods containing high amounts of oats, barley, and psyllium (found in products such as Metamucil) to make the claim that soluble fiber from these sources may reduce the risk of heart disease. Numerous studies have found that people who eat more dietary fiber are less likely to develop heart disease. In an analysis of 10 observational studies, published in the Archives of Internal Medicine in 2004, each 10-g-a-day increase in dietary fiber was associated with a 14 percent decrease in heart attacks and related heart problems and >> FIBER see page 25

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MHL HEALTHWISC JUNE 2011

WHAT IS INSOMNIA?

INSOMNIA (IN-SOM-NE-AH) IS A COMMON CONDITION IN WHICH YOU HAVE TROUBLE FALLING OR STAYING ASLEEP. THIS CONDITION CAN RANGE FROM MILD TO SEVERE, DEPENDING ON HOW OFTEN IT OCCURS AND FOR HOW LONG. INSOMNIA CAN BE CHRONIC (ONGOING) OR ACUTE (SHORT-TERM). CHRONIC INSOMNIA MEANS HAVING SYMPTOMS AT LEAST 3 NIGHTS A WEEK FOR MORE THAN A MONTH. ACUTE INSOMNIA LASTS FOR LESS TIME. SOME PEOPLE WHO HAVE INSOMNIA MAY HAVE TROUBLE FALLING ASLEEP. OTHER PEOPLE MAY FALL ASLEEP EASILY BUT WAKE UP TOO SOON. OTHERS MAY HAVE TROUBLE WITH BOTH FALLING ASLEEP AND STAYING ASLEEP. AS A RESULT, INSOMNIA MAY CAUSE YOU TO GET TOO LITTLE SLEEP OR HAVE POOR-QUALITY SLEEP. YOU MAY NOT FEEL REFRESHED WHEN YOU WAKE UP.

OUTLOOK Secondary insomnia often resolves or improves without treatment if you can stop its cause—especially if you can correct the problem soon after it starts. For example, if caffeine is causing your insomnia, stopping or limiting your intake of the substance may cause your insomnia to go away. Lifestyle changes, including better sleep habits, often help relieve acute insomnia. For chronic insomnia, your doctor may recommend a type of counseling called cognitive-behavioral therapy or medicines.

OVERVIEW There are two types of insomnia. The most common type is called secondary or comorbid insomnia. This type of insomnia is a symptom or side effect of some other problem. More than 8 out of 10 people who have insomnia are believed to have secondary insomnia. Certain medical conditions, medicines, sleep disorders, and substances can cause secondary insomnia. In contrast, primary insomnia isn’t due to a medical problem, medicines, or other substances. It is its own disorder. A number of life changes can trigger primary insomnia, including long-lasting stress and emotional upset. Insomnia can cause excessive daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. This can prevent you from doing your best at work or school. Insomnia also can cause other serious problems. For example, you may feel drowsy while driving, which could lead to an accident. JUNE 2011 HEALTHWISC MHL

Most of the eye acts like a lens, focusing images and light onto the back of the eye, known as the retina, which functions like film in a camera.

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Arvind Saini, M.D. The eye works very much like a camera. Most of the eye acts like a lens, focusing images and light onto the back of the eye, known as the retina, which functions like film in a camera. At the very front of the eye is the transparent cornea. All light first passes through the cornea before it enters the eye, like light passes through a camera lens. Just as a camera is useless if the lens cap is in place, the eye cannot see images clearly if the cornea is damaged or irregular. The surface of a normal cornea is remarkably smooth. Think of it as a perfect crystal. It is made of many layers that are perfectly organized one on top of the other, so that the cornea remains clear and light can pass easily through it, without distortion. Therefore a clear cornea is critical to good vision. Any irregularity in this “lens” can distort your vision. Anterior Basement Membrane Dystrophy, also known as “ABMD”, is a common condition causing distortion in the superficial layers of the cornea. Anterior basement membrane dystrophy goes by many other names, such as epithelial basement membrane dystrophy “EBMD”, or “map-dot-fingerprint” dystrophy. ABMD is primarily a degeneration of the corneal surface. Most experts feel that it is not inherited, but rather a degeneration of the corneal surface, just like osteoarthritis is a degeneration that can occur in your joints. Just like osteoarthritis, different people will have the condition to varying degrees. ABMD is the most common degeneration of the cornea, affecting 2% of the population, however only 1 in 10 people that have the condition will have symptoms. In ABMD the main problem is that the layer of cells that covers the surface of the cornea does not grow across the surface smoothly. This is because deposits form between the superficial layers of cells. These deposits cause irregularity in the surface of the cornea, which can lead to symptoms. The main symptoms that people experience with ABMD are erosions and visual distortion. Erosions are small defects that form in the surface cells on the cornea when the cells rub off. The deposits that occur in ABMD result in an abnormally weak adherence of the superficial cells to the layers underneath. Loss of superficial cells occurs more easily than in a normal eye. Erosions usually occur after waking in the morning, or in the middle of the night, and are more common in eyes that are dry. They can be very small or cover a large part of the corneal surface. They can result in sudden tearing and redness. The pain from an erosion can range from mild irritation to severe pain and light sensitivity. This pain, tearing, and redness will resolve as the surface heals in hours to days, depending on how large the erosion is. Because of the underlying disease, newly healed cells may not adhere tightly to the surface of the cornea, creating a risk for repeat erosions. Another symptom that can occur in ABMD is blurry vision. This usually will occur later in the disease process when people are older. Some people may never have erosions, but only run into problems when they notice blurry vision. This >> EYE see page 46

THE ROCKET:

SPICY, GREEN

arugula takes off

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Lori Zanteson, Environmental Nutrition THE FOLKLORE. Arugula dates back to Roman Times, but it wasn’t until the 90s that this peppery green established itself in high-end U.S. restaurants during the Mediterranean food wave. Grown for its deep green leaves, as well as the seed which flavors oils, arugula is commonly served in a salad of mixed greens. Incidentally, arugula—also known as rocket, roquette, rugula and rucola—was thought to have aphrodisiac qualities. THE FACTS. Nutritionally, this rocket shoots for the stars. Aromatic and peppery, with a slight mustard-like flavor, arugula (Eruca sativa) is part of the Brassica family, which includes broccoli, cabbages and mustards, thought to be cancerpreventive. In keeping with its healthy lineage, arugula has the nutrient punch of both its cruciferous relatives and leafy green vegetables. It is rich in vitamins A, C and K, folate and calcium, and is very low in calories. A one-cup serving provides 28% of the daily value (%DV, daily recommendation based on 2,000 calories per day) of vitamin D, which is important for blood-clotting, and 10% DV of vitamin A in a mere four calories. THE FINER POINTS. The popularity of arugula unleashed the variety now available in the marketplace. Choose wild arugula, baby arugula, micro-arugula, or standard arugula, depending on the boldness of flavor desired. Arugula’s untamed bite pairs well with other fresh greens, and its spice is a good foil to many ingredients like goat cheese, citrus and nuts. It’s a natural on sandwiches, with pasta or eggs, and sautéed with vegetables. Give this long-known staple of Italian cuisine a try, and see how easily this rocket charms.

THE FINDINGS. Arugula’s natural phytonutrients, called indoles, appear to alter favorably estrogen metabolism, thus potentially reducing the risk of breast cancer. Arugula is high in flavonoids, which have been shown in test tube and animal research to possess anti-carcinogenic activity, as well as antioxidant, antiinflammatory and antiviral effects. Beta carotene, lutein and zeaxanthin— arugula’s carotenoids—are powerful antioxidants that are important for health. Lutein and zeaxanthin have been found to reduce the risk of agerelated macular degeneration, while beta carotene is protective against sun damage. The antioxidant properties of arugula extract showed protective and anti-ulcer activities against gastric lesions in an animal study published in the April 2009 World Journal of Gastroenterology. EN’s Own Rocket Salad Vinaigrette 1 shallot minced 1 Tbsp parsley, coarsely chopped 2 Tbsp sherry vinegar Dash salt & pepper ¼ cup lemon-infused extra virgin olive oil Salad 3 cups baby arugula 1 cup fresh basil leaves 2 cups radicchio 1 cup seedless red grapes, sliced ½ ounce goat cheese, crumbled To prepare vinaigrette: In medium bowl, add shallot, parsley, vinegar, salt and pepper. Whisk in olive oil. To prepare salad: In large bowl, toss arugula, basil, radicchio and grapes. Toss with vinaigrette. Top with crumbled goat cheese. Serves 6. Nutrition Information per serving: 112 calories, 1 grams (g) protein, 5 g carbohydrates, 9 g fat, 38 milligrams sodium, 1 g dietary fiber.

Reprinted with permission from Environmental Nutrition, 52 Riverside Dr., Suite 15-A, New York, NY 10024.

For more information, visit www.AuroraPharmacy.org. For a location near you, call 1-888-973-8999. © AHC

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JUNE 2011 HEALTHWISC MHL

allergies &HAY FEVER

If you suffer from sneezing, runny noses, or itchy eyes, you might think you have a cold. Instead, it could be an allergy. When you come across something that you are allergic to, your body reacts by producing chemicals. These chemicals cause the sneezing, runny nose and itchy eyes. People can be allergic to many different things, such as > POLLEN > DUST MITES > ANIMAL DANDRUFF > MOLD > FOODS DRUGS

HAY FEVER Hay fever (pollen allergy) is one of the most common kinds of allergies. About 35 million Americans suffer from hay fever. Pollen is made by trees, grasses, and weeds. During the spring, summer, and fall some plants release pollen into the air you breathe. Your symptoms might be different at different times of the year. It all depends on the kinds of plants that grow where you live and what allergies you have. SYMPTOMS OF HAY FEVER > SNEEZING > RUNNY OR CLOGGED NOSE > COUGHING > ITCHY EYES, NOSE, AND THROAT > WATERY EYES > RED, SWOLLEN EYES

Why do some people have allergies and hay fever? No one is sure what causes allergies. You are more likely to have hay fever if your parents have it. What kinds of tests check for allergies? •SKIN TESTS- Your doctor may also use a needle to put a small amount of allergen into your skin. After a few minutes, the reaction tells your doctor if you have allergies. •BLOOD TESTS- Your doctor may use a blood test to look for a protein in your blood called IgE. This protein is made by people with allergies and hay fever. It also helps fight certain types of infection. Both tests look for certain disease-fighting cells (antibodies). Your body makes these cells to match whatever it is fighting. Your antibodies tell doctors what you are allergic to. How are allergies and hay fever treated? Your doctor can help you decide what to do. You can: •AVOID THE THINGS THAT CAUSE YOUR SYMPTOMS. •USE MEDICINES. •GET ALLERGY SHOTS. Allergy shots contain small amounts of what you are allergic to. At first, shots may be given every week to lessen your symptoms. The shots are usually continued for 3 to 5 years. MHL HEALTHWISC JUNE 2011

EDITOR’S

PICK

Men’s Road Bike 2011 Podium 3 - DiamondBack

OVERVIEW - DBR 7005 Aluminum Performance Road Frame - DBR Carbon Podium Fork w/Alloy Steerer - FSA Gossamer Compact BB30 Crankset - Shimano 105 Derailleurs & 10-Spd Dual Control Shifters - Shimano R-500 Wheel Set

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Women’s Road Bike 2011 Capri 4 - Raleigh

RE2P (Relaxed Ergonomic Effective Position) geometry: Designed for the new Capri, our Raleigh-exclusive Women’s RE2P creates a more confident, upright position that reduces body stress and fatigue to achieve an overall increase in performance. The result is an all day ride that strikes a perfect balance of speed, efficiency and comfort. Achieving this blend requires manipulating the shape of each lightweight butted Atomic 13SL aluminum tube to its optimal form for function. Adding our own Women’s Specific RE2P geometry, with increased seat angle and shorter toptube. reduces the reach to the handlebars, lowers the stand over and gives a more upright position that produces a ride that is unmatched for miles of enjoyment

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Choosing the Best Bicycle for You By Chris Kegel and Peter Flucke For the Bicycle Federation of Wisconsin The best bicycle for you is the one that suits your needs. As a child you probably did not care what you rode, which is fortunate because you probably did not have a choice. Whatever mom or dad bought you or whatever you could salvage was fine. As long as the wheels went around and the tires had at least some air, you were ready to go (brakes were optional!). But times have changed. Now you do have a choice. Now you can choose the bicycle’s type, size, frame material, components and even color, ultimately choosing the best bike for you. The first step in selecting the right bike for you is to determine where you would like to ride. Will you be riding mostly on-road or off-road? Do you want to travel at a leisurely pace or do you want to race? Will you be riding for fitness, for recreation or to work? Any bicycle can take you where you want to go; it’s just that some types of bicycles do it better than others. The five general types of bikes are: mountain, road, hybrid, comfort and recumbent. Each has its advantages and disadvantages depending on the kind of riding you want to do. Mountain bikes Designed for off-road use, they have wide, heavily treaded, low pressure tires, strong compact frames, straight handlebars and an upright riding position. In many ways a mountain bike is like a sport utility vehicle. Advantages: sure footed, nimble, durable Disadvantages: more wind and rolling resistance on smooth roads; noisy and bumpy ride, slow Road bikes are built for on-road riding and speed. They have narrow, smooth, high pressure tires, drop handlebars, an aerodynamic riding position and a narrow seat. A road bike is like a two-seater sports car. Advantages: less wind and rolling resistance; on-road, smooth and quiet, fast Disadvantages: less stable in dirt or gravel, harsh ride on rough roads. Hybrids A hybrid is a cross between a mountain and a road bike. They have midwidth, moderately treaded, medium pressure tires, straight handlebars, an upright riding position and a wider seat. This type of bike is very popular for riding around town and for light trail use. Advantages: Smoother ride than a mountain bike and more stable than a road bike Disadvantages: Less stable off-road and slower on-road Comfort bikes These are modified mountain bikes designed to be more tame for the less aggressive rider who values comfort. They have wide, smooth treaded, medium pressure tires, high handlebars, an upright riding position and a wide, soft seat. Advantages: Smooth, soft, stable ride Disadvantages: Slow on-road and less nimble off-road Recumbent bikes These bikes look like reclining chairs on wheels. The rider sits close to the ground with legs extended horizontally to pedals in front. Although different, this type of bike is gaining popularity. Advantages: very comfortable and fast on-road Disadvantages: different feel from a regular bike, inability to stand up. Bikes come in many sizes, so picking the correct size is important. General size recommendations for adults when standing flat-footed over the top bar are: Recreational mountain bikes: Allow 2 to 3 inches of clearance. (More aggressive riders should have 3 to 5 inches.) Hybrids: Allow from 1 to 3 inches of clearance. Road bikes: Allow approximately 1 inch of clearance. Other factors such as seat height, seat fore and aft position, handlebar height and reach also play a part in proper bike fit. See your local bicycle shop for assistance. The frame determines the majority of the bike’s riding characteristics. Steel, aluminum, carbon and titanium are all materials used in building bikes. The key is not what material is used but rather how well it is made. Lightweight frames are good, but they must also be strong. A bike’s components -- gears, derailleur, chain, crank and brakes, for example -- are important. Better quality pieces will work like new years from now. Get the best that you can afford. Your intended use and buying style will determine what makes sense. Once you know the type of bike you want and have selected size, frame material and components, the most fun is choosing the “look,” i.e. the color. A bike shop is the best place to buy a bicycle. The staff is knowledgeable and can assist you with your choice. Having a relationship with a bike shop is also helpful when it is time for repairs. Furthermore, get to know your new bike. Start with short rides at first and build up gradually. Recapture your youth. But this time, first choose the best bicycle for you. Bike Fed Board Member Chris Kegel is the owner of the Wheel & Sprocket bicycle stores in Wisconsin, Peter Flucke is the president of WE BIKE and both are members of the Bicycle Federation of Wisconsin.

JUNE 2011 HEALTHWISC MHL

GARDENING

10 MHL HEALTHWISC JUNE 2011

Growing Home Grown in the Contemporary Victory Garden

Everything from classic herb gardens to urban chicken coops are popping up all over America! Today we feel apprehensive about the future and in the garden, the old adage “you reap what you sow” finds life. This revival is borne from that

sense of self-sufficiency and the touch-it-feel-it kind of independence that comes from growing home grown! Victory gardens were planted during

WWI and WWII to support war efforts and to grow vegetables, fruits and herbs for families so that commercial resources could be used to nourish our soldiers overseas. Today, in the United States and abroad, there are many socioeconomic and cultural factors that “ripen the vine” for this revival. In America… - We again have many men and women serving overseas. The original victory gardens, also called war gardens or food gardens for defense, appeared during times of war. - We are more focused than ever on health and nutrition. We want to eat organically and are either skeptical of the true nature of the available products or don’t want to pay for them. - Again due to our commitment to good health, we aren’t afraid to roll up our sleeves, get a little dirty and work up a sweat! Heck, gardening can save a trip to or a bill from the gym. After an hour in the garden, we’re likely to have burned off around 300 calories. - We have an increased awareness of pesticide use and contaminants in commercially grown produce and the use of antibiotics in the poultry, dairy and livestock industries. - We are concerned about the amount and affects of fossil fuels required to transport food. Did you know that the average piece of produce travels 1500 miles before it lands on your plate?! - We have the desire to buy American. Better yet, we’d like to utilize local resources, support neighborhood businesses and farms and be involved in community activities. - We would like to provide assistance to the large number of hungry Americans and donate our harvests to food banks and shelters. - We want to share this renewed sense of self-sufficiency and show our kids what really matters most in life! Through this recession, our collective obsession with material things and the concept of “money buying happiness” has diminished. - We remember that old, disfigured pear tree growing over the swing-set at Grandma’s and the garden we spent so much time weeding in our folks’ backyard. During difficult times, we long for those that were more carefree and simple. In this regard, although our carrots might be crooked and our apples blemished, the garden doesn’t disappoint! At Lied’s, we see this trend gaining steam through our clients’ requests and in the types of projects we are partnering on together. More and more frequently, we have the opportunity to help our clients design and establish plots, build and maintain coops, protect crops by adding fencing, responsibly manage insect and disease problems, and even install devices to collect rainwater for use in the patch. Our reward? Well, besides the obvious, our clients always share! Just to name a few, we’ve enjoyed vine-ripe tomatoes, super-sized zucchinis, homemade pickles and even fresh brown eggs! Here at Lied’s, we find ourselves doing a little of the heavy lifting to get our clients ready to reap and sow. But, usually our clients save most of the “work” for themselves...but wouldn’t you too?!

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Where to Get Gardening Help? Knowledge is a gardener’s best tool. With knowledge and good resources that cover all aspects of your yard and garden, you can troubleshoot problems and come up with great solutions. Luckily we live in the information age. Thanks to the Internet, TV, radio, and books, we have more access to more free information than ever before, but with so many resources available, how do you recognize the best gardening authorities and the most reliable sources of information? No matter how long you’ve been gardening, sooner or later you’re going to run into a problem that you can’t figure out alone. Where do you turn for help? Here are some great sources of gardening information — beyond traditional books and TV shows — that can help to turn a potentially disastrous problem into a successful solution. Web Sites — We live in the Internet age and information is just one google search away. It s important to find Web sites that offer accurate, accessible information. For example, the National Gardening Association (NGA) Web site features articles, pest and weed libraries, plant finders, calculators, how-to projects, regional gardening information, and more. Developed with decades of gardening experience, it s a one-stop

location for a wealth of gardening information. Online Forums — Online forums, uch as Dave’s Garden, are another great source of information. At Dave’s Garden you can “meet” gardeners with similar interests and problems and chat with them about their experiences. Of course, many users of online forums are amateurs, and their suggestions may be very personal and site specific, but these sites offer a good way to network, find links to other information sources, and build a community of gardeners. Blogs — Other gardeners are a great source of gardening-specific information. If your neighbor isn’t a gardener, try finding one on the Internet and reading their blog. Try googling for gardening blogs in your region. Read through a few to see which you like best. Some offer more than just gardening how-tos. For example, The Garden Rant features gardening information as well as political and social commentary about gardening, health, social issues, the environment, and more. It’s a fun read and informative. Video — People have less time than ever before to sit and read information. Perhaps that’s why Internet videos have become so popular. Plus, gardening is

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yoga

FOR YOUR HEALTH

Yoga is a mind-body practice in complementary and alternative medicineA group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. (CAM) with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditationA conscious mental process using certain techniques—such as focusing attention or maintaining a specific posture—to suspend the stream of thoughts and relax the body and mind. or relaxation. This Backgrounder provides a general overview of yoga and suggests sources for more information.

14 MHL HEALTHWISC JUNE 2011

People use yoga for a variety of health conditions and to achieve fitness and relaxation. It is not fully known what changes occur in the body during yoga; whether they influence health; and if so, how. There is, however, growing evidence to suggest that yoga works to enhance stress-coping mechanisms and mind-body awareness. Research is under way to find out more about yoga’s effects, and the diseases and conditions for which it may be most helpful. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. Yoga in its full form combines physical postures, breathing exercises, meditation, and a distinct philosophy. Yoga is intended to increase relaxation and balance the mind, body, and the spirit. Early written descriptions of yoga are in Sanskrit, the classical language of India. The word “yoga” comes from the Sanskrit word yuj, which means “yoke or union.” It is believed that this describes the union between the mind and the body. The first known text, The Yoga Sutras, was written more than 2,000 years ago, although yoga may have been practiced as early as 5,000 years ago. Yoga was originally developed as a method of discipline and attitudes to help people reach spiritual enlightenment. The Sutras outline eight limbs or foundations of yoga practice that serve as spiritual guidelines: 1.yama (moral behavior) 2.niyama (healthy habits) 3.asana (physical postures) 4.pranayama (breathing exercises) 5.pratyahara (sense withdrawal) 6.dharana (concentration) 7.dhyana (contemplation) 8.samadhi (higher consciousness) The numerous schools of yoga incorporate these eight limbs in varying proportions. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes two of the eight limbs: postures (asanas) and breathing exercises (pranayama). Some of the major styles of hatha yoga include Ananda, Anusara, Ashtanga, Bikram, Iyengar, Kripalu, Kundalini, and Viniyoga.

THE STATUS OF YOGA RESEARCH

Research suggests that yoga might: > Improve mood and sense of well-being > Counteract stress > Reduce heart rate and blood pressure > Increase lung capacity > Improve muscle relaxation and body composition > Help with conditions such as anxiety, depression, and insomnia > Improve overall physical fitness, strength, and flexibility > Positively affect levels of certain brain or blood chemicals. More well-designed studies are needed before definitive conclusions can be drawn about yoga’s use for specific health conditions.

SIDE EFFECTS AND RISKS

Yoga is generally considered to be safe in healthy people when practiced appropriately. Studies have found it to be well tolerated, with few side effects. People with certain medical conditions should not use some yoga practices. For example, people with disc disease of the spine, extremely high or low blood pressure, glaucoma, retinal detachment, fragile or atherosclerotic arteries, a risk of blood clots, ear problems, severe osteoporosis, or cervical spondylitis should avoid some inverted poses. Although yoga during pregnancy is safe if practiced under expert guidance, pregnant women should avoid certain poses that may be problematic.

IF YOU ARE THINKING ABOUT YOGA

Do not use yoga as a replacement for conventional care or to postpone seeing a doctor about a medical problem. If you have a medical condition, consult with your health care provider before starting yoga. Ask about the physical demands of the type of yoga in which you are interested, as well as the training and experience of the yoga teacher you are considering. Look for published research studies on yoga for the health condition you are interested in. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about CAM

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Becoming Real: Harnessing the Power of Menopause for Health and Success

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By Kalpana (Rose) M. Kumar, MD Over the past two decades as a practicing physician, I have seen thousands of women transition through peri-menopause. This is a time filled with a myriad of symptoms at physical, psychological, emotional, energetic and spiritual levels. For decades women have been seeking a framework from which to understand this process in order to awaken to their true and real selves. Our society lacks the framework to facilitate this transformational process. Our medical system medicates the symptoms of this transformational time and women are left feeling dismissed and invalidated within the medical model. In my medical practice, I strive to orient women through their powerful and often frightening midlife changes from a perspective that is honoring of who they really are. Midlife is a call for women to dismantle the identities they have acquired in order for them to fit in to society. These identities are not real and they leave women feeling lonely and empty. Over time, they become disconnected to their authentic selves and their intrinsic power. Midlife women feel an intense need to shed this conditioned self and to live out of their authenticity. They have difficulty pretending to be who they are not. They have a difficult time living from the identity that their roles as mothers, wives, homemakers or professionals offer them at the cost of their intrinsic value. After living from these external definitions for over a third of their lives, they begin to feel restless to connect with their real selves. They feel deep sadness at the loss of connection to their true selves and deep rage if they are not supported in their transformational process. Most women have a great degree of imbalance in their lives and find they spend their time caring for others at the cost of self. They feel depleted. Many become depressed and anxious if they are unable to transform into their real selves in midlife. Many times this transformation is marked with a midlife event that is traumatic and it facilitates a woman’s process of becoming real. In our society we refer to this as a midlife crisis. For all women, this time is marked by hormonal changes. In my book, I offer a framework for the peri-menopausal woman to help her understand and orient herself through what can sometimes feel like a chaotic process. With an understanding of the physiological changes menopause evokes and the levels in the inner life that these changes activate, women will be able to dispel their fear of this powerful process and engage self-compassion and self-care as they reweave their identity from one that is adapted to one that is real. This time, marked by hormonal shifts is referred to as the ‘medial’ time. It is a time when a woman leaves the world of expectation behind and enters the world of ‘soul’. At this time of her life, her soul must be obeyed and she must be able to understand and speak its language. She must transform into her true self and behave in ways that do not compromise her true nature. It is here that she can access her intrinsic power and reclaim herself from the >> REAL see page 17

16 MHL HEALTHWISC JUNE 2011

Stomach Acid: Friend or Foe? Kelly A. Simms, Resident Naturopathic Physician Integrative Family Wellness Center What do anemia, osteoporosis, depression, and asthma have in common? They are just a few of the conditions that have been linked to having LOW stomach acid. Conventional treatments have lead the population to believe that stomach acid is a culprit that causes painful heartburn and is something that needs to be suppressed or eliminated. The reality is that nature put the acid there for a reason and low acid is actually to blame for many conditions. Stomach acid allows the food that we eat to be broken down into amino acids, vitamins and minerals. People that take acid suppressing medication have been shown to have increased rates of osteoporosis (malabsorption of calcium and vitamin D), anemias (malabsorption of iron or the B vitamins), and depression (malabsorption of amino acids that are then made into neurotransmitters). Stomach acid signals the closure between the esophagus and stomach. Without the acid, there is no signal to close the connection and it remains open. Without complete closure, symptoms or heartburn may occur. Over 80% of childhood asthmas can be linked to low stomach acid. In asthma research, children less than seven years old have been found to have low stomach acid. When acid production picks up in the late childhood and adolescent years many children can have spontaneous “cure� or are told that they “outgrow� asthma. Children with asthma who are treated with acid replacement therapy often have asthma remission, begin to gain weight (due to nutrient absorption), have better eating habits, and are less susceptible to colds and flu. Stomach acid acts as a protective barrier from the outside environment. The air we breathe and the food we put into our bodies are the main point of entry for microorganisms and potential toxins. The acid in the stomach acts to kill any potential harmful bacteria. For example, decades ago in India cholera was epidemic. For some reason, parts of certain villages did not contract the disease and remained relatively well. The people who did not get sick were actually found to have higher levels of acid in their stomach which allowed the bacteria to be killed before it was able to colonize and cause harm in the digestive tract. In general, those with low stomach acid may have frequent illness or may be more at risk for low immune function. Luckily, there are many natural treatments for low acid. Treatment may include betaine hydrochloride acid replacement, pancreatic enzymes, bitter herbs, and dietary modification. Acid replacement therapy can be initiated based on mineral analysis, gastric symptoms, history of taking acid suppressing medication or diagnosis with any of the associated diseases listed above. Testing and evaluation is necessary before stopping any acid reduction therapy and beginning natural treatments.

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soul loss she may have suffered as an adapted woman. Obeying the world causes us to abdicate our power. Obeying our soul helps us to reclaim it. This time is so powerful that it has the ability to heal a lifetime of wounding and facilitate the formation of a new and meaningful life. It is a sacred time that needs to be consecrated by our culture and by women who are actively in this process. With one billion women in the world in midlife, it is necessary to reframe this time as one of power and alchemy from one of pathology. The restlessness that midlife women feel is healthy and powerful. It has in it the answers to the problems that we are facing in our hurting world. We must hold space for this peri-menopausal time in a natural and organic way, with reverence and respect for the process of transformation. We must view the symptoms of the menopausal transition at all levels from a natural place rather than a pathological one and we must honor the power of this process. There is a better way to transition than what we have been offered thus far. I encourage you to question how you may have adapted to the world of expectation and how you can honor the world of your soul. Every woman that transforms into her real self will bring light and authenticity to our world. ŠKalpana(Rose)M.Kumar,MD March2010 Kalpana (Rose) M. Kumar, MD is board certified in Internal Medicine and the founder and Medical Director of The Ommani Center for Integrative Medicine in Pewaukee, WI. She has been in practice for more than 20 years, focusing her practice on integrative medicine and women’s health. Her forthcoming book, entitled Becoming Real: Harnessing the Power of Menopause for Health & Success, is scheduled for publication in early Summer, 2011. Contact her at www.ommanicenter.com Ph: 262.695.5311 JUNE 2011 HEALTHWISC MHL 17

reiki-infused acupuncture WHAT IT CAN DO FOR YOU By: Erica M. Zernzach C.Ac. (514-055), MSOM, BS Nutrition & Reiki Master Teacher A Right Path Wellness, LLC - Acupuncture and Eastern Medicine Is your stress level out of control? Are you short tempered with your children or co-workers? Do you have a health issue that you feel will never be resolved? Then Reiki-Infused Acupuncture may be the next step for you to take. Reiki is translated as “universal life-force energy.” It is vital to our very existence and it keeps us living, moving and developing. Reiki is a useful healing technique. It can restore your energy and productivity, allowing you to be more resilient in the

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journey of life. In order for a Reiki practitioner to be able to utilize and guide this healing energy to benefit you, they must be trained and receive what we call an attunement by a Reiki Master Teacher. Once this Reiki attunement has taken place, the practitioner simply places their hands on or above another person to allow the energy to flow smoothly through the individual. This simple yet powerful healing has been known to bring comfort to many: from the common migraine sufferer to cancer patients. Similarly, Acupuncture also uses our body’s energy through what is referred to in Traditional Chinese Medicine as meridians. These pathways are energetic highways of the body. Acupuncture needles are inserted on specific sites of the meridians to guide energy stimulation, sedation or a mixture of both depending on the health issue. In addition to these energetic meridians, it is believed that we all have seven energy wheels that are commonly referred to as chakras. Both the meridians and the chakras are correlated with different emotional, physical and spiritual attributes. When the energy flows unevenly or incorrectly it can create havoc in our bodies. Reiki is similar to the philosophy of Traditional Chinese Medicine in several ways. Both are ancient natural healing modalities and practiced world-wide. Reiki allows the energy we already have inside to be guided and balanced, similar to the actions produced by Acupuncture needles. Balance of the body, mind and spirit is the collective goal. With the joined efforts of Reiki and Acupuncture, these tools can assist the meridians and chakras to function at their highest peak. Reiki-Infused Acupuncture stimulates the energy of the body, bodily fluids and chakras. It helps erase reminisce of old stale energy that blocks our health from sustaining. Receiving a session from one of these ancient Eastern healing practices can be life-changing. Often when we are overstressed or out of sync, our body sends out warning signals that something is wrong (body pain, anxiety, hypertension, diabetes, etc). Alternatively, when we are running on all cylinders appropriately and living in balance disease cannot exist. These techniques focus on harmonizing the energy of the body to calm the mind, invigorate the energy to heal on a physical level and stimulate clarity or mindfulness to reach your core and spirit. A Reiki-Infused Acupuncture treatment involves several steps. The treatment room and Acupuncture tools are saturated with Reiki healing energy. Once the Acupuncture needles are inserted, Reiki is performed during the entire Acupuncture treatment. In addition, Reiki is continued after the needles are removed to complete the healing session. The healing energy of Reiki and Acupuncture sets the stage for optimal results. When using Reiki-Infused Acupuncture, the practitioner only facilitates the space for healing to occur. The client is using their own energy as the healing vehicle. Their energy is responsible for health to manifest. Combining these two powerful tools allows the healing to be an advanced hybrid. Both healing art forms compliment and enhance the other perfectly. A helpful analogy for health is to imagine that we are like onions. We have various layers that create our physical, emotional and spiritual make-up. In order to achieve balance and health, we must pull away layers to get to the core of the issue. Reiki can enhance the strength of Acupuncture, therefore peeling deeper levels that other techniques leave untouched. Reiki and Acupuncture are self-regulating and self-knowing. When applied by a skilled practitioner both techniques can either remove or replenish the proper amount of energy for healing to take place. Reiki-Infused Acupuncture can be used on almost any health concern – from the most minor to the most severe. Reiki assists the Acupuncture needles to calm the spirit and help you feel grounded. Therefore, it is therapeutic in treating stress and emotional health issues. Both techniques may positively affect the bodily systems, chemical structure of the body, helping to restore muscles, nerves, bones and organ functions. Many have seen significant reductions in stress, increase in energy levels, elimination of pain and a decrease in blood pressure. It will influence anything in the body that needs to be awakened and healed. People often leave the treatment feeling calm, relaxed, yet energized and clear-headed to focus on the day. The benefits are endless. Treatment frequency and duration are based on the severity of the issue and the length of time it has been afflicting your life. Reiki-Infused Acupuncture can be restorative for anyone at any age, especially when a person feels physically, emotionally or spiritually stuck. It can give the extra push so that they may reach the next level of healing. According to the testimonial from C.K. of Thiensville, Wisconsin, “The first time I was treated with Reiki-Infused Acupuncture, I felt the energy flowing through the needles. Having had Acupuncture in the past, I was surprised at the vital energy I felt. It was incredible to feel the two modalities (Acupuncture and Reiki) working together to produce significant results. The healing force felt multiplied.” ReikiInfused Acupuncture helps make your world appear clearer and brighter. It can help bring back enjoyment to your life. It can help lay the foundation for healing miracles to occur. Combining these two powerful healing tools can manifest unlimited potential for your health. For more information, contact Erica M. Zernzach at 414-651-2850 or visit ARightPath.com.

TEA TIME

WHAT’S ALL THE FUSS ABOUT

GREEN TEA?

Drinking tea regularly may be one of the most practical lifestyle changes you can make... David Schardt Nutrition Action HealthLetter Green tea is hot. You can buy a bottled green tea beverage just about anywhere these days. And food manufacturers are adding green tea or its extracts to everything from coffee (one Eight O’Clock coffee blend has compounds from green tea “gently infused� into its beans) to juice drinks (V8 V-Fusion contains “the natural goodness of green tea�).

STROKE “Drinking tea regularly may be one of the most practical lifestyle changes you can make to significantly reduce your risk of suffering a stroke,� says epidemiologist Lenore Arab of the University of California at Los Angeles. Arab co-chaired the Fourth International Scientific Symposium on Tea and Human Health in 2007. She and her colleagues pooled the results from 10 studies—of nearly 200,000 people in China, Japan, Finland, the Netherlands, Australia, and the United States— that looked at tea consumption and stroke risk. (The meta-analysis was funded by Unilever, which owns Lipton.) The benefit of drinking tea came shinning through no matter where people lived in the world,� says Arab. Those who drank at least three cups every day had a 21% lower risk of suffering a stroke compared with those who drank less than a cup a day. If this turns out to be true, that’s a pretty strong finding for something that’s the third leading cause of death in this country,� notes Eric Rimm, director of the Program in Cardiovascular Epidemiology at the Harvard School of Public Health in Boston. Rimm says “if� because the studies that Arab’s team examined weren’t designed to prove cause and effect. “There’s a strong association, but we don’t know if there’s something about the people who drink tea that would account for their having fewer strokes,� explains Rachel Johnson, a professor of nutrition at the University of Vermont and a spokesperson for the American Stroke Association. What’s needed, she says, is a trial that randomly assigns people to drink either tea or an indistinguishable tea-free placebo. If tea matters, is green tea better than black? (Green tea comes from the unfermented leaves of the plant Camellia sinensis, while black tea is made from the fermented leaves.) In Arab’s meta-analysis, it wasn’t. But in animal studies, compounds in green tea called polyphenols seem to protect lab animals against damage caused by strokes. For example, when researchers induce strokes in gerbils, Arab explains, the animals’ brains suffer less damage if they are first fed a tea polyphenol called EGCG (epigallocatechin gallate.) If the same is true in humans, green tea may help stop strokes from becoming severe enough to be noticed. So-called “silent� strokes are common, and are far less damaging than major strokes. “At least 10% of people older than 65 have damage to the white matter of their brains, which is probably evidence of silent strokes that didn’t cause paralysis or pain or other symptoms that would lead them to be diagnosed with stroke,� says Arab. “When I’m asked when is the best tine to drink tea, I say right before your stroke!� she jokes. So should you start drinking three cups of green tea every day to protect your brain? It’s far too early to say. It’s much more important to keep your blood pressure under control by shedding pounds if you’re overweight, eating less salt and more fruits and vegetables, and taking blood-pressure-lowering drugs if necessary. PROSTATE CANCER “The evidence that green tea prevents the development of prostate cancer in men is not very encouraging,� says researcher Susanne Henning of the Center for Human Nutrition at the University of California at Los Angeles. For example, in four studies that followed more than 95,000 men in Japan and Hawaii for 7 to 20 years, those who drank the most tea had no lower overall risk of >> TEA see page 54

Be the Change You Want to See!

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LOW BACK PAIN Low-back pain is a common condition that can be difficult to treat. Spinal manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. is among the treatment options used by people with low-back pain in attempts to relieve pain and improve functioning. It is performed by chiropractors and other health care professionals such as physical therapists, osteopaths, and some conventional medical doctors. This fact sheet summarizes the current scientific knowledge about the effects of spinal manipulation on low-back pain.

20 MHL HEALTHWISC JUNE 2011

Each year, up to one-quarter of U.S. adults experience low-back pain.

KEY POINTS Evidence indicates that spinal manipulation can provide mild-tomoderate relief from low-back pain. It appears to be as effective as conventional treatments, and recent guidelines for health care practitioners include it as a treatment option for pain that does not improve with selfcare. Spinal manipulation is generally a safe treatment for low-back pain. The most common side effects (e.g., discomfort in the treated area) are minor and go away within 1 to 2 days. Serious complications are very rare. Recent research into spinal manipulation for low-back pain has begun to look at the effects of different forms of manipulation, as well as treatment duration and frequency. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

ABOUT LOW-BACK PAIN Each year, up to one-quarter of U.S. adults experience low-back pain. Most people have significant back pain at least once in their lives; often, the cause is unknown. Back pain varies widely. For many people, it lasts only a few weeks, no matter what treatment is used. But for others, the pain can become chronic and even debilitating. Low-back pain is a challenging condition to diagnose, treat, and study.

SPINAL MANIPULATION AND LOW-BACK PAIN Spinal manipulation—sometimes called “spinal manipulative therapy”—is practiced by health care professionals such as chiropractors, physical therapists, osteopaths, and some conventional medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine, moving it beyond its passive range of motion. The amount of force applied depends on the form of manipulation used. The goal of the treatment is to relieve pain and improve physical functioning. In the United States, spinal manipulation is often performed as part of chiropractic care. ChiropracticA whole medical system that focuses on the relationship between the body’s structure—mainly the spine—and function. Practitioners perform adjustments (also called manipulation) with the goal of correcting structural alignment problems to assist the body in healing. is a health care approach that focuses on the relationship between the body’s structure—mainly the spine—and its functioning. In chiropractic, spinal manipulation is sometimes called “adjustment.” Back problems are the most common reason people seek chiropractic care.

Chiropractic is a health care profession that focuses on the relationship between the body’s structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment approaches, they primarily perform adjustments (manipulations) to the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function, and supporting the body’s natural ability to heal itself.

JUNE 2011 HEALTHWISC MHL 21

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People with chronic pain are twice as likely to suffer from depression and anxiety as those without it.

By Diane Halloran O.T Chronic pain can occur at almost anytime for any reason: arthritis, neck and back pain, headaches, TMJ, Fibromyalgia, after a surgery or for some unexplained reason. Pain is the number one reason that sends people to the doctor. Half of those that seek relief do not get it. Pain provokes an emotional response in everyone. If you have pain, you may also have high anxiety, irritability, and agitation. These are very normal feelings when you are hurting. Normally, when pain subsides, so does the stressful response. Chronic pain exists beyond what we consider as a normal healing period. People with chronic pain are twice as likely to suffer from depression and anxiety as those without it. If you have chronic pain and depression, you’ve go plenty of company, half of the 32 million people in the United States alone experience chronic pain and depression. Depression is one of the most common psychological issues facing people who suffer from chronic pain. It is now clear that there is not single pain center in the brain. Pain is an interactive dance along neurotransmitters in the brain and spinal cord. Much chronic pain is thought to involve either an overactive pain-perception circuit or and under active pain-modulation unit. In other words, with chronic pain, our nervous system is has gone rogue making it difficult to stop the signals of pain sent to the brain creating an escalating cycle. Furthermore, it is believed that more pain pathways are created with chronic pain in the Central Nervous System while nerve cells that normally inhibit or slow the signaling, increase or decrease function. O.K., now what does that mean in terms of treatment of pain? If pain affects not only your body, but your mind and spirit, then treatment must address these three aspects of the human condition. Exercise and stretching are beneficial. Done in combination with mind-body techniques that increase endorphins – neurotransmitters that allow the body to feel good, exercise becomes even more favorable. Medications such as anti-inflammatories are effective in the short term, but there are worries about long-term use. Painrelief medication is often abused and one can become easily addicted. In therapy, mind-body techniques can decrease or wean clients from medications that they thought they absolutely needed for pain relief: Medications that can have negative long term effects. Mind-body techniques such as yoga and meditation are helpful in the treatment of pain as they help activate and allow us to more easily regulate our pain-modulation unit. Mind-body techniques can also be used in combating depression especially as our perception changes. Relaxation techniques that involve the body and mind can be beneficial in letting go of physical stress that exacerbates pain. Once the pain cycle is decreased, the central nervous system is trained to fire less which decreases its pain pathways. With less pain, our spirit lifts and the future seems brighter. Written by Diane Halloran O.T., an occupational therapist with Wholistic Occupational Therapy who has been effectively treating pain with integrative techniques for over 10 years located at 6320 W. North Avenue. For more information and/or a free consultation, call 414-258-2981.

THE NATURAL QUALITIES OF

oriental medicine Dr. William F. Hughes, Jr. PhD., Dipl. AC. Traditional Chinese Medicine (TCM) has been continuously practiced for over 3,000 years and is the oldest and most successful medicine in history. TCM is comprised of many forms of natural medicine including herbal medicine, acupuncture, massage, nutrition, Tia chi and Qi Gong. Let’s take a look at these components and you will see why this medicine is the fastest growing medicine in the United States. Before we go into the individual components we must first look at the total of TCM to understand how everything fits together. The Taoist version of behavior translates to relentless perfection. The Tao is called “The Way” because it helps to guide behavior. It is peaceful and kind, but it adheres to its principles that like water, a person should bend but not break. This philosophy guides Oriental Medicine to help a person have the most fulfilling life possible. TCM preaches moderation in life. Do not wear out the body with excessive exercise or activity. Our society is beginning to see the disasters that affect our star athletes. From on the field and/or court we see injuries during games or practice. Also, ailments by athletes as they age are legendary and early death seems likely. So, moderation is the word, in work or play. The TCM Doctors feel you have a better chance at living a good, long life in moderation and that is not a bad goal for anyone. In addition to moderation, Oriental Medicine is concerned with a person’s “balance” in both physical and mental terms. Most of the treatments, both herbal and acupuncture, are aimed at restoring balance in a patient. A person who is in “balance” is a healthy person and thus the goal of TCM is to maintain a person’s “balance” in all things. We have come to some of the various practices that comprise what is called Traditional Chinese Medicine (TCM). Today herbs are being used by more Americans for a variety of ailments. Herbs are quite safe and can treat symptoms that Western Medicine cannot. With the introduction of TCM in the last 30 years, herbal medicine is growing in popularity because it helps in healing and it is natural. Acupuncture is at the most visible form of TCM in the United States. TCM doctors are licensed in all States and must pass National Boards in order to practice, at least in Wisconsin that is true. Acupuncture helps patients with pain and a great host of other problems by adjusting “Qi” and removing stagnations. Basically, the acupuncturist is attempting to “balance” the body using thin needles. This aspect of TCM is making positive news all across the country. Give acupuncture a try and find out if a balance treatment can help you.. Massage in TCM is called Tui Na and in China it is more like massage therapy and chiropractic combined. In this country it is limited to massage. Again the goal of Tui Na is to move the “Qi” and remove stagnation using body massage and acupressure. Nutrition is a cornerstone in TCM. After all, what you eat is important to your healthy balance. Moderation is again suggested as one way to keep healthy. Every day it seems that there is a new problem in the American diet and we are starting to stray from common sense and listening to the advertising as though it was fact. We need to pay better attention to the real basis of nutrition , and your TCM doctor can help you with a good nutrition program. Tai Chi is a form of oriental martial arts that is scaled back so everyone can participate. From the young to the old, Tai Chi can help to create and maintain a healthy body. A recent study found that Tai Chi dramatically helped the balance of senior citizens. A better balance means fewer broken bones. Qi Gong is another physical TCM program that has wonderful results. Qi Gong is a series of movements that co-ordinate breathing and movement. These exercises increase a person’s energy and mental alertness. This is a low impact program that can be done by anyone, any age and in almost any physical condition. The above discussion, while brief, hopefully sheds a little light on the breadth and scope of Traditional Chinese Medicine. It is this attention to patient’s overall life and habits that has resulted in a successful and long term medicine. Today, the philosophy of natural health food and natural medicine, simply reflect what TCM has known for centuries. Good health is a gift and we must be careful in what we eat and how we live. We invite you to join the many people who are benefiting from Traditional Chinese Medicine. For more information contact, Acupuncture Clinic of Wauwatosa, Inc., 11611 West North Avenue Suite 101, Wauwatosa, WI 53226, 414-607-0900.

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Dr Hughes is a graduate of UW-Madion, The Midwest College of Oriental Medicine and Belford University. He and his wife/office manager, Connie, have been residents of the Elm Grove area for 21 years where they have raised their four children. He is a member of Elmbrook Rotary.

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appetite and exercise

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By Amy Goldwater, M.S. Does exercise influence appetite? Does exercise increase appetite? Does exercise stimulate hunger? The answers to these are the same as for many of life’s meaningful questions: Yes and No! Theories abound concerning the mechanisms that regulate food intake. Some sources indicate that the hypothalamus (the part of the brain that regulates appetite) closely monitors levels of certain nutrients in the blood. When these levels fall, the brain signals us to eat. Scientists distinguish between hunger, an inborn physiological response to nutritional needs, and appetite, a learned response to food that is tied to an emotional or psychological craving and is often unrelated to nutritional need. In some instances, the problem with overconsumption may be more related to satiety than to appetite or hunger. People generally feel satiated, or full, when they have satisfied their nutritional needs and their stomach signals, “No more needed, thanks!” In overweight people, it is possible that the monitoring system does not work properly and the cues to eat are more frequent and intense. Hormones Some researchers are focusing on the hormones leptin and peptidYY, which scientists believe signal the brain when a person is full and needs to stop eating. It is believed that if we can enhance these levels in the blood, people may find it easier to control their hunger urges. A hormone produced in the stomach—known as ghrelin—may be among the most important players in our collective difficulties in keeping weight off. Researchers at the University of Washington studied a group of overweight people who had lost weight over a six-month period. They noted that ghrelin levels rose before every meal and fell drastically shortly after every meal, suggesting that the hormone plays a role in appetite stimulation. Exercise Here’s where the Yes and No answers come in: There are studies that suggest that exercise suppresses the appetite by affecting appetite hormones. While some research suggests that exercise stimulates hunger and food intake, most short-term studies (where hunger and food intake are evaluated right after the workout) do not find this to be true. In fact, vigorous exercise has been found to reduce hunger, although the effect is temporary and unlikely to have a longterm impact on overall food intake. A criticism of these types of studies is that hunger and food intake were not tracked for a long enough time period. In a study where participants were followed for up to 14 days, researchers found, on average, that 30% of the calories burned during exercise were compensated for. In other words, people increased their food intake by a small amount, but not nearly enough to cover the total calories burned during physical activity. Emerging research suggests there may be a degree of individual variation in hunger in response to exercise. For example, in a 2009 study where participants followed a 12-week exercise program, participants that did not lose weight reported significant increases in total daily hunger compared with the participants who lost a significant amount of weight. Behavioral reasons Another cause for eating more in response to exercise may be due to behavioral reasons (“I worked out, so now I can have a bowl of chips”). Overestimating calories burned during exercise and underestimating food intake is a common occurrence. There are people who increase the amount of calories they eat after they start exercising as a sort of reward for working out. Some make high-calorie food choices based on the fact that they’ve burned off extra calories and feel entitled to a splurge. Unfortunately, the treat may end up being higher in calories than the calories that were burned off while exercising, resulting in a positive calorie balance. According to a new study, a vigorous 60-minute workout on a treadmill affects the release of two key appetite hormones, ghrelin and peptide YY, while 90 minutes of weight lifting affects the level of only ghrelin. The research shows that aerobic exercise is better at suppressing appetite than nonaerobic exercise. This line of research may eventually lead to more effective ways to use exercise to help control weight. While the study showed that exercise suppresses appetite hormones, the next step is to establish whether this change actually causes the suppression of eating. The bottom line is that there are many factors conspiring to affect our appetite and eating habits. Recognizing these factors and making conscious decisions to change lifestyle behaviors is an important step in maintaining a healthy weight. Amy Goldwater, M.S., is a physical fitness expert and educator. Amy, coauthor of TOPS’ lifestyle guide The Choice Is Mine, is a full-time health and physical education instructor at the Milwaukee Area Technical College and is a personal trainer and fitness consultant for private and corporate clients. She holds several national bodybuilding titles. Amy writes several website articles about fitness each year for TOPS.

<< FIBER see page 4 a 27 percent decrease in the risk of dying of a heart-related problem. How might fiber reduce the risk of heart disease? Cholesterol plays a key role in the production of bile acids, substances that are essential for digestion. When soluble fiber passes through the digestive system it grabs onto bile acids in the small intestine and removes them via the stool. This forces the liver to convert more of its cholesterol into bile acids and to pull the cholesterol it needs for the job from the bloodstream, reducing blood levels of low-density lipoprotein (LDL, or “bad”) cholesterol. Help With a Healthy Weight? Most studies find that people feel less hungry after eating fiber, and several studies even point to weight loss. One possible reason why: Eating fiber forces you to chew more, causing the body to secrete more saliva and stomach acid. This causes your stomach to expand temporarily and make you feel full. A 2001 review article published in Nutrition Reviews found that getting an extra 14 g a day of fiber caused people to eat less and lose more than 4 lbs in about four months. People who were obese seemed to benefit even more, losing an average of 5 lbs. Protection from Type 2 Diabetes Evidence suggests that fiber may offer some protection against type 2 diabetes. For example, in a 2007 article based on data from the very large Nurses’ Health Study, women were 21 percent less likely to develop type 2 diabetes for each twoserving increment in daily intake of whole grains (this was after adjusting for factors such as body weight). If you have diabetes, several studies have found that adding soluble fiber to the diet helps stabilize blood glucose levels. Fiber may accomplish this by slowing the rate of absorption, thus moderating the blood glucose spike that typically occurs after we eat carbohydrates. Help with GI Blues The traditional reason to increase your fiber intake is to stay regular. Regularity varies greatly among people and is affected by factors such as your genes, the amount of exercise you get, and your stress levels. Still, if you’re healthy and you are experiencing constipation—defined as three or fewer spontaneous bowel movements per week—make a point of getting more

fiber from whole-grain cereals and other sources. Fiber makes bowel movements easier by increasing the weight and size of the stool. The fiber itself and the water it absorbs both add to the weight and bulk of stools. Fiber fermentation further increases the weight by boosting the amount of bacteria in stool. This overall increase in bulk makes it easier for the colon to propel stools through the digestive tract. When it comes to specific gastrointestinal (GI) problems, the evidence is less compelling. For example, fiber is used as a treatment for irritable bowel syndrome (BS), which can cause diarrhea and constipation as well as bloating, straining, and urgency. So far studies looking at fiber’s effectiveness for IBS have had inconsistent results. However, a 2008 review published in BMJ found that supplements of psyllium (found in Metamucil) were better than a placebo at relieving IBS symptoms. Fiber has not yet been proven to prevent diverticular disease, another common GI problem. Diverticula are pouches in the colon caused by herniations of the soft, inner layer through weak areas of muscle. These pouches can become inflamed, a condition called diverticulitis. This can cause abdominal pain, bleeding, infections, and small tears or blockages in the colon. Ease of elimination may explain why people who get adequate fiber are less likely to develop diverticular disease. Experts consider it reasonable for people with the condition to eat a high-fiber diet to prevent the formation of additional pouches. The bottom line: Fiber has been shown to help keep your heart healthy, and research suggests it may also help control your weight, reduce the risk of diabetes, keep your bowels regular, and help with GI issues. So, if your typical day starts with coffee and a Danish, there’s good reason to switch to high-fiber cereal and fresh berries. Reprinted permission of the Johns Hopkins Medical Letter Health After 50, copyright MedLetter Associates, 2011. To order a one-year subscription, call 386447-6313.

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FOOT PAIN

BIG TOE ARTHRITIS How To Beat A Joint Into The Ground

The big toe is a key joint in the foot which, because of the high repetitive forces that pass through it with all weight-bearing activities, is unusually susceptible to arthritis in middle age and older adults.

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WHAT IS IT? Arthritis (osteoarthritis) is a gradual and debilitating breakdown of the body’s joints due to routine wear and tear, overuse and mechanical abuse. The big toe is a key joint in the foot which, because of the high repetitive forces that pass through it with all weight-bearing activities, is unusually susceptible to arthritis in middle age and older adults. Arthritis features a number of negative changes to joint tissues and function. The most important change is the thinning and eventual disappearance of joint cartilage. Cartilage is the smooth, lubricated surface at the ends of the bones in all normal joints that is responsible for normal function. It allows the joint to move smoothly with minimal friction and is capable of handling large compressive forces without pain or damage to the joint. It has no nerve endings so even heavy loads are not usually painful. When a joint is subject to routine, abnormal wear and tear or unusual mechanical strain, the cartilage may be worn thin or obliterated completely. The cartilage develops cracks or fissures, loses its lubrication and the cells gradually die. The involved joint becomes swollen and painful; excess bone frequently develops along the joint margins (called “lipping”) as a response to the abnormal trauma and tends to progressively limit joint range of motion as the arthritis advances.

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HOW DID I GET IT? The big toe is designed to take the majority of stress as the forefoot loads and we propel ourselves forward with each step. When the main arch of the foot flattens (flat feet), though, the big toe function becomes limited by abnormal ligament restraint. The toe cannot raise upwards when the forefoot is loaded but the forward motion of the foot occurs anyway, forcing the joint into a position it cannot assume freely. This forcing of the big toe motion is abnormally stressful to the joint. Over time, the joint begins to show the negative changes of arthritis described above. The base of the big toe becomes thicker, begins to swell especially after prolonged weightbearing activities, and gets progressively stiffer and painful with age. Bad weather may elicit soreness in the joint because it promotes swelling. Besides poor foot mechanics due to flat feet (most common), arthritis of the big toe may come from a sports injury, a traumatic accident or the medical condition known as gout.

HOW IS IT TREATED? Arthritis is best treated in its early stages before the joint loses most of its range of motion. As with most foot problems, there are two main concepts in treatment: 1) reduce the symptoms, and 2) address the underlying cause. ANTI-INFLAMMATORY AGENTS: These may include ice and oral anti-inflammatory medications. These may provide some temporary relief and ease the pain of inflammation, but are not helpful in addressing the underlying cause of your condition. sure off the big toe should be followed. A stiff-soled shoe with a rocker or roller bottom may be recommended to help you walk and lessen the bend in the big toe. A shoe with a wide toe box may also help relieve pain. Avoiding high heels and weight loss are other important considerations. Surgery: In advanced cases that do not respond to conservative measures, your doctor may recommend surgery. There are a few common surgeries that are performed depending on the degree of arthritic changes. Removal of the bone spurs, joint fusion, and complete joint replacement can be performed. These procedures are not without risks and often the disease continues to progress after a temporary period of pain relief. Also, operative measures performed on one foot may have negative effects on the other foot due to the excessive load. Custom Arch Supports: This is truly the most effective way to treat and even reverse the development of arthritis at all but the most advanced stages of the disease. The right custom made supports will address your pain by restoring correct arch height and function, effectively releasing the big toe, allowing it to unlock and function properly. When this is done, the cause of your pain is being addressed rather than just the symptoms. A C•A•S•T™ insert, unlike typical custom arch supports, is designed to completely restore and reinforce the corrected arch of your foot, determined by a unique way of capturing your optimal foot position. Abnormal joint stresses can be reversed, allowing affected tissues to heal and normal joint function to be restored. In this way the C•A•S•T™ support provides both primary treatment and preventative care by restoring normal weight bearing function and range of motion to your big toe. Most arthritic conditions of the great toe respond favorably to proper arch support management if addressed early enough. This paper provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your health care provider. These may provide some temporary relief and ease the pain of inflammation, but are not helpful in addressing the underlying cause of your condition. For more information contact Foot Solutions at 262.241-3668.

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BOOT UP FOR BOOT CAMP Arlene Becker Boot camps have been around for a very long time. They were originally developed for men who joined the Army or the Marines who were put through vigorous training for several weeks, until those, who had been couch potatoes, and not too fit, turned into iron men. If you flunked Boot Camp, you had to do it all over again until you finally passed. “For the civilian population the idea of a rigorous boot camp in a health club setting didn’t pop up until the last several years,” observed Pam Koch, who’s part of the management staff at the Elite Sports Clubs, “Now there’s the phenomenon of wanting to participate in them. “ “Slow to grow initially,” Koch continued, “Boot Camps now seem to be popping up everywhere. They were prominent, of course, first on the west coast, for example in California. Now most health clubs, as well as independent trainers in Southeast Wisconsin and in other Wisconsin cities, are offering some sort of Boot Camp or with the philosophies of a Boot Camp. The popularity of these classes are evident and the participants say they love the challenges,” Koch said,” and they motivate you to work harder then.” Though Boot Camps can differ from club to club, they seem to have the same philosophy in mind, a rigorous training regime in the forty-five minutes to hour classes. Annie Farley, who is the Group Exercise Director of the Mequon Elite Sports Club, said that some of the appeal for Boot Camps is, in addition, to its intense workout is that it has seemed to generate a lot of camaraderie within the group. “Here at Elite we’ve tried to develop a program that fosters people to encourage each other to continue in the program even if they find it a bit challenging in the beginning. There are even many exercises that are co-operative like the relays where people touch hands when someone comes to the relay’s finish line, where one finishes and the next goes on, it’s almost like team sports. We do ab workouts with a medicine ball where partners toss the ball to one another.” “For variety, we do a lot of work outside, even in inclement weather, so it’s really like a true army boot camp, except I’m not like an army sergeant there’s no yelling or castigating. Our classes are a full hour three times a week, which we feel is just the right amount of time, giving people a chance to recover between classes.” ONE WEEK PRE-SCAMP Elite Sports Clubs proudly celebrates its Farley continued, “On Tuesday and Thursday June 13 - 16 Full Day 25th year of SCAMP with a tradition of we do a more traditional Boot Camp which includes running, squats, and push-ups. We Half day / Full day safe, healthy, summer fun. Our licensed day also do, plyometrics, which is using propulsive 3 WEEK SESSIONS, Mon. - Thurs. camps provide an incredible agenda of ageSession I June 20 - July 7 movement to develop strength and power. appropriate, kid-friendly fun. Session II July 11 - July 28 People think of Boot camp as mostly running Session III August 1 19 and jumping and push-ups and that’s basically SCAMP now in Elite facilities in Brookfield what it is, however we add things to make it more effective for the total person.” & Mequon offers spacious environments, ONE WEEK POST SCAMP “Inside the building we use traditional boot camp equipment and when we are Aug. 22 25 Full Day outside we use equipment like tires for jumping in and out of, which increase each featuring indoor & outdoor pools, peoples’ flexibility and balance, and sandbags which people carry or use as we indoor tennis courts, full-sized gyms, dance would use weights in the gym. “ studios, Kids EZone rooms & more. Farley went on, “We also use an agility ladder which participants jump in and out of, a bit like hop-scotch, with the added bonus of heavy cardio.” On Fridays we do something entirely different working with different equipment which isolates different muscles groups. We also use TRX straps which were developed by Navy Seals to supplement core strength for a strength work-out. We do many exercises with them. We also use kettle bells, a strength based tool which is a valve shaped weight with handles. Friday is a strength focused day.” “I’ve personally seen a new proliferation of Boot Camps in the greater Milwaukee area and I see that not every Boot Camp may be like ours. Each has its own style, but basically the philosophy of working the entire body to its maxim capability. Boot Camp is most effective with people who already have a pretty good fitness base, who’ve been working out for some time and want to take their fitness challenge to SWIMMING! the next level.” TENNIS! “Our job,” Farley explained, “as the people who run Boot Camp classes, is that we want to work you out but to prevent injuries and to give each participant a KARATE! 262-241-4250 challenge that would personally suit that individual.” ARTS & CRAFTS! 11616 N. Port Washington Rd. “To see if the person is a prime candidate for our Boot Camp classes we offer the Mequon, WI 53092 THEME DAYS! first class free so that the person can see if it’s for them and then we can assess their fitness level so we know it’s the right place for them.” FIELD TRIPS! 262-786-0880 Farley said only fitness is the determination if someone should take Boot Camp 13825 W. Burleigh Rd. classes, not age. “We have women in their twenties to a woman in her early sixties Brookfield, WI 53005 there’s no cut-off age wise it’s really more of a fitness thing.” For more information and to sign up for a free introductory class call The Mequon Elite Sports Club at 1-262-241-4250 or visit the Elite website at www. register online EliteClubs.com elitesportsclubs.com

an Elite Day Camp

What c

28 MHL HEALTHWISC JUNE 2011

day Mom? o t o an we d

STRESS

A NEW LOOK AT AN OLD PROBLEM: PART 3

By Avi Bernstein, MD, Adult (Internal) Medicine When was the last time you breathed? When was the last time you listened to deafening quiet? When was the last time you sat down to do nothing and answer to no one? In Parts 1 & 2 of the series Stress!!! A New Look At An Old Problem, we explored a new approach to understanding what modern stress “is” and how it affects our health. Now, we focus on what we can do about it. Take this typical example of a “stressed-out” working parent of young kids: The day begins for Mom and Dad at 6 am with the blaring beeps of the alarm clock. An early wake-up is necessary because of a long commute to work. Mom showers and gets dressed. She puts on her suit and notices that it feels a bit tight. Dad goes in to work later so he helps get everyone off on their days. He fills Mom’s extra-large thermos with coffee. He makes breakfast for the kids but their 12 year old daughter sneers , still very angry from last night’s fight. On the way to work Mom listens to the radio which seems to have a lot of irritating songs and cackling disc jockeys. Mom is happy to see her colleagues at work, but is dreading the 10 am meeting with the boss. At that meeting, Mom’s boss tells her that the reports aren’t analytical enough, almost as if they were written by a high school student. Mom is furious, hurt, and scared. She wants to punch her boss in the nose and, in fact, felt a surge of adrenaline during the meeting. Her feelings are hurt. She scolds herself for this, telling herself “why should I care what that moron says?” She’s scared because she knows jobs are tight and they’re expecting another child; the car payments for the new BMW are high; and they really shouldn’t have stretched so far to get their dream house…she shudders at the thought of losing this job. In this example, we recall several forces that seemed to increase tension: • Exposure to noxious stimuli • Confining forces over our bodies or minds • Unvented emotions, and • Unnecessary financial stress We might ease our stress by lessening these factors in our daily lives. How would the same day feel if it unfolded as follows? The day begins for Mom and Dad at 6 am with the soft music of the alarm clock. They find this is enough to wake them because they went to sleep at 10 pm the night before. An early wake-up is necessary because of a long commute to work but the pain of stop-and-go traffic is shared carpooling with a neighbor who works nearby so they pass the time in pleasant conversation (while they save on gas!). Mom showers and gets dressed. She puts on her suit and notices that it feels a bit tight and makes a plan to purchase more comfortable work clothes at the next opportunity. Dad goes in to work later, so he helps get everyone off on their days. He fills Mom’s “to-go mug” with half regular/half decaf coffee. He makes breakfast for the kids, but their 12-year old daughter sneers at Mom, still very angry from last night’s fight. Mom sighs, sits down to face her

daughter, and shares with her that she loves and wants the best for her and feels hurt when her daughter treats her with disrespect. On the way to work, when conversation wanes with her neighbor, Mom enjoys the quiet. She remembers the screaming kids at home and the office phones blaring which are sure to come. She feels the rhythm of her own calm breathing and enjoys the moment. The more she enjoys the quiet, the calmer she becomes. She feels her heartbeat slow down and her muscles relax. She hadn’t realized she was gripping the steering wheel so hard! At work Mom meets with the boss who tells her that her reports aren’t analytical enough, “almost as if they were written by a high school student.” Mom is furious, hurt, and scared. She wants to punch her boss in the nose and, in fact, felt a surge of adrenaline during the meeting. Her feelings are hurt. After the meeting, her assistant tells her that there is a call waiting on the line. Mom inquires about the call’s urgency. Learning it is non-urgent, she tells her assistant to take a message. Mom leaves the building and takes a slow walk around the grounds which has lots of trees and a pond. She calls her husband to “vent” her feelings and he tells her that he loves her and will cook spaghetti for dinner. She hangs up feeling better. On her way back to the building, she focuses on her breathing and looks around at the trees allowing thoughts to float away. She feels her heart slow down and realizes that she is lucky to have a good marriage, a job, and laughs to herself as she ponders what an unhappy fool her boss must be. “Furthermore”, she thinks, “if I get canned at least we’ve got a small house and two older vehicles…we’ll be ok”. As we witness Mom navigate her day in these two scenarios, consider how different is the exposure to noxious stimuli, confining forces over the body or mind, the burden of unvented emotions, and unnecessary financial stress. Which Mom do you think would be less stressed? As part of my practice in Internal Medicine, I teach patients relaxation exercises and we discuss easy lifestyle changes to achieve less daily stress. It is a pleasure to watch them “de-stress” and I believe that you can accomplish this, too! Here’s an example of an exercise you can do: Sit back in your seat (or lie down). Take a moment to slow your breath and feel your heart rate slow down. Then squeeze your fist tight for 5 seconds, feeling the tension in the muscle. Relax the muscle and enjoy that feeling of letting tension go. Repeat this with all the muscles in your body and you’ll soon find yourself a relaxed and refocused person! If this is done consistently for a few weeks, a change takes place in the mind almost similar to anti-depressant effect. There is a reason that people have been doing similar meditative exercises for thousands of years…try it! Avi Bernstein, MD, is a board certified internist practicing with Metro Physicians-Wheaton Franciscan Medical Group, in Milwaukee at 2025 W. Oklahoma Avenue, Suite 100, and in Franklin at 7400 W. Rawson Avenue, Suite 213. For more information, please call 414-389-2790. JUNE 2011 HEALTHWISC MHL 29

FAMILY HEALTH AND LIVING

FAMILY HEALTH

photo by Mike Nepper 4877E11

30 MHL HEALTHWISC JUNE 2011

make family time active time

You might think that the goal for children to be moderately physically active for 60 minutes seems like a lot of time. Life does get in the way, but it doesn’t have to. Make getting more physical activity a family project. Encourage everyone to think of fun things to do to get up and moving, get off the sofas, and away from the screens—especially doing things as a family. -There are hundreds of ways to enjoy physical activity together as a family. _ -Bike to the library together -Walk or bike to your children’s sports events to cheer for them -Have your children come to your sports events and cheer for you -Celebrate special occasions—birthdays, anniversaries—with something active, such as a hike, a volleyball game, or a Frisbee™ match -Train together for a charity walk or run -Do a family art project Keep a family activity log Encourage everyone in the family to take part and keep up the good work by posting a physical activity log on the refrigerator. Everyday ideas to rev up activity Encourage every member of your family to increase daily physical activity. Think of ways to have fun and be physically active at the same time. Here are some everyday ideas to rev up activity.

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CHILDREN’S POSTURE

AND COMPUTER WORKSTATION SET- UP

The use of computers in schools has grown rapidly over the past several years. This growth is likely to continue since it is believed that computers enhance children’s ability to learn. Of course, outside the school, children are participating in more computer based social activities as well, sometimes spending hours at a computer. This is why it is so important to ensure that the workstation is adequate in order to Early interventi prevent repetitive stress injuries and other musculoskeletal injuries.

matic impact symptoms and TIPS FOR HEALTHY POSTURE WITH USING A COMPUTER:child’s ability learn new skills • Maintain good upper body posture-shoulders back and not rounding forward

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over keyboard. • Sit back in the chair and ensure a “neutral” back(maintaining the three natural curves of your spine) • Keep feet firmly on the floor or footrest for support • Do not tilt head back too far or too far forward-keep computer screen at or just below eye level. • Upper arms should be close to side of body and elbows bent to 90 degrees. • Keep wrists in neutral position, using wrist pad as necessary to avoid excessive wrist extension while typing or using mouse. • Bring items in the work area as close to the screen as possible as to avoid twisting his/her head unnecessarily. • Manage computer use time. The risks of any postural problem associated with computer use depends on the length of time your child uses the computer without taking a break. You can use software programs to regulate your child’s computer use or you can watch a clock. Simple wrist, head and neck stretches can be done during these breaks to also avoid injury. ‘ Call Advance Physical Therapy Services LLC if your child has pain or injury associated with computer use! 414-422-4678

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tion has a draon reducing d increasing a autism spectrum disorders are more common in the pediatric population than to growThe and are some better known disorders such as diabetes, spinal bifida, or Down syndrome. s. Prevalence studies have been done in several states and also in the United Kingdom,

Europe, and Asia. A recent study of a U.S. metropolitan area estimated that 3.4 of every 1,000 children 3-10 years old had autism.This wide range of prevalence points to a need for earlier and more accurate screening for the symptoms of ASD. The earlier the disorder is diagnosed, the sooner the child can be helped through treatment interventions. Pediatricians, family physicians, daycare providers, teachers, and parents may initially dismiss signs of ASD, optimistically thinking the child is just a little slow and will “catch up.” Although early intervention has a dramatic impact on reducing symptoms and increasing a child’s ability to grow and learn new skills, it is estimated that only 50 percent of children are diagnosed before kindergarten. All children with ASD demonstrate deficits in 1) social interaction, 2) verbal and nonverbal communication, and 3) repetitive behaviors or interests. In addition, they will often have unusual responses to sensory experiences, such as certain sounds or the way objects look. Each of these symptoms runs the gamut from mild to severe. They will present in each individual child differently. For instance, a child may have little trouble learning to read but exhibit extremely poor social interaction. Each child will display communication, social, and behavioral patterns that are individual but fit into the overall diagnosis of ASD. Children with ASD do not follow the typical patterns of child development. In some children, hints of future problems may be apparent from birth. In most cases, the problems in communication and social skills become more noticeable as the child lags further behind other children the same age. Some other children start off well enough. Oftentimes between 12 and 36 months old, the differences in the way they react to people and other unusual behaviors become apparent. Some parents report the change as being sudden, and that their children start to reject people, act strangely, and lose language and social skills they had previously acquired. In other cases, there is a plateau, or leveling, of progress so that the difference between the child with autism and other children the same age becomes more noticeable. Signs & Symptoms Parents are usually the first to notice unusual behaviors in their child. In some cases, the baby seemed “different” from birth, unresponsive to people or focusing intently on one item for long periods of time. The first signs of an autism spectrum disorder can also appear in children who had been developing normally. When an affectionate, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or indifferent to social overtures, something is wrong. Treatment There is no single best treatment package for all children with ASD. Decisions about the best treatment, or combination of treatments, should be made by the parents with the assistance of a trusted expert diagnostic team. JUNE 2011 HEALTHWISC MHL 33

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34 MHL HEALTHWISC JUNE 2011

pain YOU CAN GET HELP

Schedule a “Just in Case” Tour of The Jewish Home Rehab Get the answers you’ll need while you have the time and presence of mind to ask them. Questions like... r r r r r r r r r r

Do you take my insurance? How big are the rooms? Can I bring in some furniture from home? What kind of activities can I expect ? What is the food like? Where will I take my meals? Will I be stuck in my room all day? What is it like there? Is the staff friendly? What does the therapy room look like? Is the building warm and friendly or cold and austere? r What if I can’t go home again... would I want to live here?

You’ve probably been in pain at one time or another. Maybe you’ve had a bad headache or toothache—pain that doesn’t last too long. But, a number of older people have pain due to age-related illnesses like arthritis, cancer, diabetes, or shingles. These illnesses can cause ongoing pain. Some older people have many different kinds of pain. Sometimes pain can serve a useful purpose. It can be your body’s way of warning you that something is wrong. That’s why you should always tell the doctor where you’re hurting and how it feels. Describing Pain Many people have a hard time describing pain. Here are some questions to think about when trying to explain your pain: •Where does it hurt? •When did it start? Does the pain come and go? •What does it feel like? Is the pain sharp, dull, or burning? Would you use some other word to describe it? •When do you feel the pain? In the morning? In the evening? After eating? Or when? •Is there anything you do that makes the pain feel better or worse? For example, if you use a heating pad or ice pack, does that help? Does changing your position from lying down to sitting up make it better? Have you tried any over-the-counter medications for it? •Do you have other symptoms? Your doctor or nurse may ask you to rate your pain on a scale of 0–10 with 0 being no pain and 10 being the worst pain you can imagine. Or, your doctor may ask you to describe the pain using words like mild, moderate, or severe. Some doctors or nurses have pictures of faces that show different expressions of pain. You point to the face that shows how you feel. Acute And Chronic Pain There are two kinds of pain. Acute pain begins suddenly, lasts for a short time, and goes away as your body heals. You might feel acute pain after surgery or if you have

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>> PAIN see page 36 JUNE 2011 HEALTHWISC MHL 35

<< PAIN see page 36 a broken bone, infected tooth, or kidney stone. Pain that lasts for several months or years is called chronic (or persistent) pain. Chronic pain may last long after the body has healed. This pain often affects older people. In some cases, chronic pain may last long after the original injury or other cause has gone away. Some examples of chronic pain include spinal stenosis, postherpetic neuralgia following shingles, and some cancer pain.

Living with any type of pain can be very hard. It can cause many other problems such as: •Getting in the way of your daily activities •Disturbing your sleeping and eating habits •Making it difficult to continue working •Causing you to feel depressed or anxious

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36 MHL HEALTHWISC JUNE 2011

EQUAL HOUSING OPPORTUNITY

Attitudes About Pain Everyone reacts to pain differently. Many older people were told not to talk about their aches and pains. Some people feel they should be brave and not complain when they hurt. Other people are quick to report pain and ask for help. Worrying about pain is also a common problem. This worry can make you afraid to keep active; it can separate you from your friends and family. Try not to withdraw from physical or social activities because you’re afraid of being in pain. Some people put off going to the doctor because they think pain is just part of aging and nothing can help. This is not true! It is best to see a doctor if you have a new pain. Finding a way to reduce your pain is often easier if it is assessed and treated early. Treating Pain Treating chronic pain is important. The good news is that there are a variety of ways to treat pain. Some treatments involve medications, and some do not. Your doctor may make a one-of-a-kind treatment plan for you. Talk with your doctor about how long it may take before you feel better. Pain doesn’t always go away overnight. Often you have to stick with a treatment or exercise plan before you get relief. It is important to stay on this schedule. Sometimes this is called “staying ahead” or “keeping on top” of your pain. As your pain lessens, you will be more active and will see your mood lift and sleep improve. Medicines To Treat Pain Your doctor may prescribe one or more of the following pain medications. •Acetaminophen is good for all types of pain, especially mild to moderate pain. It is not habit-forming. Acetaminophen is found in over-the-counter and prescription medicines. Some people who take it may have allergic reactions like hives, trouble breathing, or swelling of tongue, lips, or face. Heavy drinkers or people with liver disease should not take acetaminophen. Often, acetaminophen is found in other pain medicines. It is important that you and your doctor know how much acetaminophen you are taking each day because it can cause liver damage at high doses. Be sure to talk with your doctor or pharmacist about safe dosages. •Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin medications, naproxen, and ibuprofen. NSAIDs may have unwanted side effects like nausea, vomiting, diarrhea, rash, dizziness, headache, or allergic reactions. More serious side effects are kidney or liver failure, ulcers, and prolonged bleeding after an injury or surgery. In some older people who have high blood pressure or heart conditions, or who have had a stroke in the past, NSAIDS can be particularly unsafe. NSAIDs are better when used for a limited time in limited doses. •Narcotics, (also called opioids) are used for severe pain and require a doctor’s prescription. They may be habit-forming. Examples of narcotics are codeine, morphine, and oxycodone. Narcotics may have unwanted side effects including constipation, sleepiness, and nausea. These side effects may occur when you begin taking the medicine, but may fade with time. Talk to your doctor about ways to manage the side effects. And, ask if there are other medications that might work better for you. •Other medications are sometimes used to treat pain. These include antidepressants, anticonvulsive medicine, and local pain killers like nerve blocks or patches. As people age, they are at risk for developing more serious side effects from medication. It’s important to take exactly the amount of pain medicine your doctor prescribes. Mixing any pain medication with alcohol or other drugs such as tranquilizers can be dangerous. Make sure your doctor knows all the medicines you take, including over-the-counter drugs and herbal/alternative supplements, as well as the amount of alcohol you drink. Don’t forget: If you think more medication would help you feel better, talk to your doctor or nurse. You might try saying, “I’m still in a lot of pain. My friend, Benny, has the same thing. He takes the same medicine, but his doctor gives him a lot more. He says his pain is almost gone.”

rehabilitaion

Focused Rehab Get Better, Get Home

GETTING BACK INTO ACTION

Each year about 700,000 people in the U.S. have a stroke and 1.1 million suffer a heart attack. The moment you survive the critical stage of a cardiovascular illness or injury is when you start the recovery phase, says Dr. Michael Weinrich of NIH’s National Institute of Child Health and Human Development (NICHD). “We have good data that people who engage in moderate activity improve their cardiovascular system,� Weinrich says. “That’s particularly true for people who have a stroke.� Results from several studies stress the role of physical activity in rehabilitation. The good news is that it’s possible to help people get enough exercise to improve their chances of recovery. Researchers supported by NIH’s National Institute of Nursing Research, for example, have found that education and encouragement promoted exercise in a rehab program for people recovering from a heart attack or bypass surgery. Physical activity speeds recovery in other areas, too. NICHD and NIH’s National Institute of Neurological Disorders and Stroke are funding a 5-year clinical study on improving the motor skills of stroke survivors. Called EXCITE (Extremity Constraint Induced Therapy Evaluation), the study is looking at how well patients recover function in an arm disabled by stroke. For a period of time, the patient avoids using the healthy arm to perform daily tasks. Instead, the arm weakened by stroke does all the work. Results so far have shown that the forced activity strengthens the weak arm and helps the stroke survivor recover motor skills faster. Joint replacement surgery is another condition for which physical activity speeds recovery. As people live longer and want to stay active, operations to replace wornout knees and hips with artificial joints have become more common. Recovering from this type of surgery means learning to walk again. Not long after your surgery, doctors and nurses want you right back on your feet. A physical therapist will plan exercises to help you retrain your muscles and adjust to using the artificial joint. You’ll probably feel some pain, but the movement will help you recover more quickly. People who’ve had injury to their nervous system after disorders like stroke want to regain more than just basic movements. They want to get back to moving the way they did before they became sick. Scientists are now testing the idea that damaged muscles may recover better and faster with help from technology. NIH-funded researchers at Arizona State University have recently designed a lightweight robotic device called RUPERT (for Robotic Upper Extremity Repetitive Therapy) that helps stroke survivors regain some basic activity in their arms. Dr. Jiping He, ASU professor of bioengineering and RUPERT research team leader, explains that the device has an advanced control system that detects the wearer’s intent to move. It can help them do the things we often take for granted, like reaching for a cup, eating or moving something from one place to another. RUPERT is being developed by Kinetic Muscles, Inc., the same company that helped ASU produce a similar device for recovering hand function called the Hand Mentor. Power for these devices is supplied by “pneumatic muscles,� small instruments that use compressed air to mimic muscle movements. Research teams funded by NICHD and NIH’s National Institute of Biomedical Imaging and Bioengineering (NIBIB) began testing the Hand Mentor last year in stroke survivors. Dr. He says RUPERT should be ready in a year or so to start testing in patients. Preliminary work is also under way for leg rehab devices. Another interesting development in rehabilitation research is an innovative movement analysis lab at NIH’s Clinical Center. Specialized video cameras record the movements of reflective markers attached to the patient’s feet, legs and hips. Sensors go on the patient’s skin to record leg muscle activity. Special plates built into the lab’s floor measure the forces exerted by the patient’s body on the floor. Once all the signals are collected by computer, the rehab team uses that information to get a very detailed idea of how the person’s joints and muscles move. They can then design a tailored recovery plan for each patient’s unique situation. �Surviving the initial phase of illness was your first success. Playing a major role in your recovery plan and adding some physical activity to your daily routine will help speed you along the way.

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HOSPITAL HINTS WHAT TO BRING It’s best to bring as little as you can to the hospital. You will need: •bathrobe and slippers (put your name on each item); most hospitals provide special hospital bed clothes •comfortable clothes to wear home (they may be the same clothes you wore to the hospital) •toothbrush, toothpaste, shampoo, comb and brush, deodorant, and razor •your hearing aids or glasses •a little cash (not more than $10) to buy newspapers or magazines Make sure you bring your health insurance card and updated information about: •past illnesses and surgeries •your medicines, including prescription and overthe-counter drugs •your allergies •names and telephone numbers (home and business) to contact in an emergency WHAT TO LEAVE HOME Leave jewelry (including wedding rings, earrings, and watches), extra cash, credit cards, and checkbooks at home, or have a family member or friend keep them for you. Don’t bring electric shavers, hair dryers, curling irons, or other equipment. Admission Once your hospital stay is planned, many hospitals have a staff member call to ask pre-admissions ques-

Has your doctor said you need a medical test that has to be done in the hospital? Do you need surgery? Most people worry when they have to stay overnight in the hospital. Learning more about what to expect and about people who work in hospitals can help. 1/2 healthwise ad for clement manor:Layout 5 3/30/11

2:03 PM

Page 1

tions over the phone. Then, when you go to the hospital, many of the forms are already filled in. Your first stop at the hospital is the admitting office. You will sign forms that: •give the hospital details about yourself, your doctor, and your insurance •explain your surgery, test, or procedure •give your okay for the medical staff to treat you You also will be asked about advance directives (see section below on Patient Rights). If you don’t have health insurance, talk with the admissions staff about other payment methods and sources of financial aid. A hospital bracelet will be put on your wrist by the admissions staff and checked by nurses. Look at your bracelet to make sure your information is correct. HOSPITAL STAFF While you are in the hospital, there may be many people who take care of you. •Doctors are in charge of your overall care. The doctor in charge may be your primary doctor (the doctor you see outside the hospital), a specialist on the hospital staff, or a hospitalist who is trained to take care of you while you are in the hospital. •Nurses – Many kinds of nurses can take care of you. For example, registered nurses can give medicines, licensed practical nurses can help feed you, and nurse’s aides can help with personal care. •Respiratory therapists prevent and treat breathing

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WHAT TO BRING It’s best to bring as little as you can to the hospital. You will need: •bathrobe and slippers (put your name on each item); most hospitals provide special hospital bed clothes •comfortable clothes to wear home (they may be the same clothes you wore to the hospital) •toothbrush, toothpaste, shampoo, comb and brush, deodorant, and razor •your hearing aids or glasses •a little cash (not more than $10) to buy newspapers or magazines Make sure you bring your health insurance card and updated information about: •past illnesses and surgeries •your medicines, including prescription and over-the-counter drugs •your allergies •names and telephone numbers (home and business) to contact in an emergency WHAT TO LEAVE HOME Leave jewelry (including wedding rings, earrings, and watches), extra cash, credit cards, and checkbooks at home, or have a family member or friend keep them for you. Don’t bring electric shavers, hair dryers, curling irons, or other equipment. Admission Once your hospital stay is planned, many hospitals have a staff member call to ask pre-admissions questions over the phone. Then, when you go to the hospital, many of the forms are already filled in. Your first stop at the hospital is the admitting office. You will sign forms that: •give the hospital details about yourself, your doctor, and your insurance •explain your surgery, test, or procedure •give your okay for the medical staff to treat you You also will be asked about advance directives (see section below on Patient Rights). If you don’t have health insurance, talk with the admissions staff about other payment methods and sources of financial aid. A hospital bracelet will be put on your wrist by the admissions staff and checked by nurses. Look at your bracelet to make sure your information is correct. HOSPITAL STAFF While you are in the hospital, there may be many people who take care of you. •Doctors are in charge of your overall care. The doctor in charge may be your primary doctor (the doctor you see outside the hospital), a specialist on the hospital staff, or a hospitalist who is trained to take care of you while you are in the hospital. •Nurses – Many kinds of nurses can take care of you. For example, registered nurses can give medicines, licensed practical nurses can help feed you, and nurse’s aides can help with personal care. •Respiratory therapists prevent and treat breathing problems. They teach exercises that help avoid lung infections after surgery. •Technicians can take blood or perform tests such as x-rays. •Physical therapists show you how to build muscle, increase flexibility, and improve coordination. •Occupational therapists work with you to restore, maintain, or improve the ability to perform every day tasks like cooking, eating, bathing, or dressing. •Dietitians can plan menus including special meals and teach you how to have well-balanced meals at home. •Clinical pharmacists may be consulted about the medicines you take. •Social workers assist you and your family. They can We are comprehensive, continuing help find home-care, rehabilitation, social services, longcare retirement communities that term care, and support groups. are at the forefront of providing Inside the Hospital senior health care services. No Hospitals have many patient-care areas. The intensive other retirement communities have care unit (also called the ICU) has special equipment and staff to care for very ill patients. Coronary care units the depth of on-site services or (CCUs) give intensive medical care to patients with heart offers fun events for active seniors. disease. In both the ICU and CCU, visiting hours are very limited. Often only family members are allowed to see patients. Surgery is done in the operating room (OR). After an operation, patients are cared for in the recovery room until they are ready to move to their hospital rooms. Independent Villas SAFETY TIPS Independent Apts Because you may feel weak or tired, here are some safety tips to follow. Assisted Living •If you are told to stay in bed, use the call bell or button when you need help. Skilled Nursing •Use the controls to lower your bed before getting in Rehabilitation or out. •Sit on the edge of the bed for a minute or so before Ventilator Care

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Hospice Care JUNE 2011 HEALTHWISC MHL 39

A New Place to Call Home THE MOVING GUIDE You’ve decided your home may be too large, too costly to maintain, too difficult to maintain, too unsafe without expensive safety features to meet your needs, too far from transportation, or too far away from shopping centers and medical offices. Your home has become an inconvenience and now you’ve decided to buy or rent a smaller home or apartment. It’s a challenge to make the move to a new place after all the years you’ve spent creating and taking care of your current home. If you own your home and plan to sell you need to consider how your life and financial status has changed. Your current home is an asset, find out how much it’s worth. Talk to your realtor about a Competitive Market Analysis

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40 MHL HEALTHWISC JUNE 2011

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so you can estimate a selling price. If you are renting and you need some advice on your move you can always find a moving coordinator to help you make the transition. Of course, many people simply choose to rely on family and trusted friends to help them make a move. You’ve spent your life helping them out, now it’s their turn to help you. We’ve put together some moving tips that should make your move easier. Decide where you want to live. Seems pretty simple, but consider many things. Would you like to be close to family, friends, shopping centers, healthcare facilities? Will you need to use transportation other than your car? Will you have access to recreational activities? Do you want to climb flights of stairs? Do you want maintenance-free living? Is it secure and safe? Do you need assistance with daily activities? Can you keep your pet? Research new home alternatives long before you make your move. Spend time in the area where you plan to move and get answers to all your questions. Whether you are moving to a smaller home, apartment, or senior residence you need to downsize your possessions. Sort through your belongings and keep what you absolutely need. Go to the least used rooms and areas first. Sort only a few hours at a time to avoid being overwhelmed. At this time you should create a floor plan of your new living space showing each room and the placement of each piece of furniture. Take measurements of each room. Make a note of doors, windows, outlets. Take measurements of your furniture. Give the remaining items to family and/or >> HOME see page 42

<< HOME see page 40

Retirement Community • • • •

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42 MHL HEALTHWISC JUNE 2011

Independent Apartments Supportive Care Assisted Living Memory Care

Sorting out senior living options? We Can Help     

friends. Think about having an estate sale, a tag sale or donating belongings to charities (many charities will pick up the items at your home). Keep in mind space limitations. Let family members know what you plan on taking with you. Make a schedule of the times when you expect to have family members, friends, or charities pick up the items. Clearly label all items, use colored stickers to mark what will or will not go to your new home. This will help you remember what goes where when you begin packing. If you plan on selling your home it’s time to make minor repairs and note major repairs which you should report to your realtor. Small repairs make the home look well cared for and usually cost little time and money. These details make a difference in how the buyer views the home. Itemize cosmetic changes such as fresh paint or new carpets. The home looks ready to move into. Be sure to keep up the exterior maintenance of your home. Remove interior clutter. All of these tips create a favorable impression on a buyer. Renters make sure your apartment is clean and contact your apartment manager to discuss what time your apartment will be shown. Packing should be easy for you and your family or professional movers if you’ve already labeled and sorted your belongings. If you are doing the move yourself be sure to have enough boxes, packing materials, and tape. Do not wait until the last minute to decide whether or not to keep an item. Make all decisions about the belongings you intend to keep long before packing day arrives. Try to do packing a day or two before you move if you are doing it yourself. Of course if you hire professional movers, let them do the packing for you. It will be less stressful on you and will guarantee that the moving company insures the contents of the boxes in case of damage. Also keep in mind that if the move takes longer because you are disorganized, the movers may charge more. Label each box with the room where it will be placed and list a few of the items contained. You can even photograph your belongings so you have a record of their condition before the move. Take special care of your smaller valuables. You’ll want to keep them separate from the other boxes. Carry them on your person, or place them with your personal items. You may even want to place them in a safe deposit box during the move. If you choose a professional mover be sure to consult two or three reputable companies and always get a written estimate. If you label all the belongings that are to be moved this will help you to receive consistent bids from potential movers. Once you decide on a mover you should sign a contract showing a specific price. Be sure to understand the amount of insurance that is provided by the mover before you sign a contract. If you have access to the internet or a library try to research what the law requires of moving companies. You’ll be better prepared to ask the right questions. You can even hire a Senior Move Manager or a Moving Coordinator to take care of all the moving details for you. This person can handle your move from assessing your belongings to decorating your new home. The National Association of Senior Move Managers has guidelines for many of these professionals. If you find the thought of a move overwhelming you may want to consider contacting a Mover Manager. Contact your utility companies and let them know what day you plan to move. Fill out change of address forms for the post office seven to ten days before moving day. Make sure you have phone service at your current home and new home on moving day. Have the name of the contact of your new apartment or senior residence ahead of time. Know the name of the person you need to contact if a situation comes up on moving day. Some residences will have you reserve a freight elevator. Make sure you know the time of the reservation. If the residence has a dining room, be sure to schedule your move around the meal times. On moving day have your family or friends help out even if you have hired professional movers, you may need to put them in charge if you find you need to take a rest from all the activity. Be sure to give the movers the floor plan with furniture placement. This will prevent confusion at your new home. Have an overnight bag packed a few days in advance of the move. This bag should have all your medications, checkbook, traveler’s checks if you are moving a distance or cash, keys, phone numbers, address book, jewelry, toiletries, night clothes, day clothes and anything important you need to have close to hand on moving day. Have pets transported safely to your new home. If you are moving a distance make sure family and friends have a copy of the route and schedule including all stops you will be making. Check all drawers, cabinets, shelves, attic and garage to be sure they are empty. Leave keys/garage door opener with new homeowner or apartment manager. Set aside time to say goodbye to your neighbors. When you get to your new home try to unpack as much as possible the first day. This will make you feel more comfortable. Check to see if the telephone is working, if you have electricity, check appliances. Ask the mailman for mail that might have been held for your arrival, notify everyone of your new change of address, make note of old mail that is still addressed to your former home. Have your new address recorded on your driver’s license, contact city offices for voter registration, register your car/license plates if moving to another state, make arrangements for local doctors, dentist, and veterinarian. Get a list of important local phone numbers and call for a local phonebook if you don’t already have one.

HOME HEALTH CARE More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications. At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state. How Do I Make Sure that Home Health Care is Quality Care? As with any important purchase, it is always a good idea to talk with friends,

neighbors, and your local area agency on aging to learn more about the home health care agencies in your community. In looking for a home health care agency, the following 20 questions can be used to help guide your search: > How long has the agency been serving this community? > Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one. > Is the agency an approved Medicare provider? > Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations? > Does the agency have a current license to practice (if required in the state where you live)? > Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for? > Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary? > Does the care plan outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver? > How closely do supervisors oversee care to ensure quality? > Will agency caregivers keep family members informed about the kind of care their loved one is getting? > Are agency staff members available around the clock, seven days a week, if necessary? > Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day? > How does the agency ensure patient confidentiality? > How are agency caregivers hired and trained? > What is the procedure for resolving problems when they occur, and who can I call with questions or complaints? > How does the agency handle billing? > Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services? > Will the agency provide a list of references for its caregivers? > Who does the agency call if the home health care worker cannot come when scheduled? > What type of employee screening is done? When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This should include an interview with the home health caregiver to make sure that he or she is qualified for the job. You should request references. Also, prepare for the interview by making a list if any special needs the senior might have. For example, you would want to note whether the elderly patient needs help getting into or out of a wheelchair. Clearly, if this is the case, the home health caregiver must be able to provide that assistance. The screening process will go easier if you have a better idea of what you are looking for first. For local information contact Comfort Keepers at 414-858-9400 or go to www. comfortkeepers.com.

JUNE 2011 HEALTHWISC MHL 43

assisted living facilities PROVIDING AN ALTERNATIVE

Quite often, adults reach a point when they should no longer live on their own but don’t need round-the-clock nursing care. Assisted living facilities provide an alternative. Assisted living is for adults who need help with everyday tasks of dressing, bathing, eating, or using the bathroom. But they don’t need full-time nursing care. Often they are part of retirement communities or are near nursing homes, so a person can move easily if their needs change. Although assisted living costs less than nursing home care, according to the U.S. Administration on Aging, it is still fairly expensive. Older people or their families usually foot the bill. Health and long-term care insurance policies may cover some of the costs. Medicare does not cover the costs of assisted living. Licensing requirements for assisted living facilities vary by state. There are as many as 26 different names for assisted living, among them: residential care, board and care, congregate care, and personal care.

Mom and dad are finding it harder to live by themselves at home. I think they need a place where they can have at least some assistance day-to-day.

Services Provided Residents of assisted living facilities usually have their own units or apartments. In addition to having a support staff and providing meals, most assisted living facilities offer at least some of the following services: • Health care management and monitoring • Help with bathing, dressing, and eating • Meals (some or all) • Housekeeping and laundry • Medication reminders and/or help with medications • Recreational activities • Security • Transportation Choosing a Facility A good match between a facility and a resident’s needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you get started in your search for a safe, comfortable, and appropriate assisted living facility:

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If you rent now, you will receive your first month’s rent FREE * Join us at Garden Place and Garden Terrace for our Summer Open House tours! • Saturday, June 18th from 10:00 am - 2:00 pm • Saturday, July 16th from 10:00 am - 2:00 pm • Saturday, August 20th from 10:00 am - 2:00 pm

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• Think ahead. What will the resident’s future needs be and how will the facility meet those needs? • Is the facility close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)? • Does the facility have limits on admitting or allowing residents to remain if they have mental impairments or severe physical disabilities? • Does the facility provide a written statement of its philosophy of care? • Visit each facility more than once, sometimes unannounced. • Visit at meal times, sample the food, and observe the quality of mealtime and the service. • Observe interactions among residents and staff. • Check to see if the facility offers social, recreational, and spiritual activities. • Talk to residents. • Learn what types of training staff receive and how frequently. • Review state licensing reports. Evalutating When you set out to evaluate a specific independent living, assisted living, or memory care residence, how do you know you are seeing the everyday ‘face’ of the facility? Below are some basic suggestions on how to proceed. Go Unannounced -Visit a residence on the weekend and observe what is happening. Caregivers should be engaged with the residents. Is there life in the community? What do you see, smell, and hear? Try to avoid scheduling a tour of the facility where they put on a show instead of letting you know what’s really going on. Talk To The Residents – Learn what residents are thinking about their community. Naturally you will hear both glowing reports as well as minor complaints, but are there any themes that repeatedly run through their comments? Are they uncomfortable, not sleeping well, bored, or unable to find anyone to listen? Dig a little deeper into complaints you hear repeatedly. Talk To The Staff – The caregivers deliver what the senior needs, so ask to be introduced and visit directly with the people ‘in the trenches.’ Ask about the rate of caregiver turnover and make certain staff is trained to handle special care needs. Review Records – Senior facilities are inspected on a regular basis. You have the right to see any reports from those inspections. When you help to make a decision affecting the most precious people in your life, remember to ask the best question of all: Would you enjoy living there?

Assisted Living and Memory Care Communities Walk through the doors of one of our Senior Living Communities and you will immediately sense the home-like and friendly atmosphere. Compassionate staff has been specially selected and carefully trained to serve with an open heart and friendly smile. Our Memory Care Neighborhoods offer specialized care for the unique needs of residents with Alzheimer’s or related dementias.

For tours and information, please contact us at (262) 432-0222.

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07 REASONS NOT TO DELAY TAKING CARE OF YOUR EYES Know you have cataracts, diabetes, glaucoma or another serious eye condition, but are hesitant to do something about it? You may find the following points motivating.

01

“Improving vision can have a substantial impact on task performance and quality of life. One study found that even with just modest visual improvement, participants could read, write, use the telephone, watch TV, and play cards better. They also reported less psychological distress (such as worry and frustration),” notes Eye Care Specialists co-founder and first surgeon in the state to perform ultrasonic cataract removal, Dr. Norman Cohen.

02

You may boost your attitude. For example, one study found that removing a cloudy cataract and improving vision can also increase the amount of light and color which enters the eye, thus positively impacting cortisol, melatonin & mood levels.

03

“Recent studies have shown that undiagnosed and untreated cataracts and glaucoma can increase the risk of car accidents. Conversely, as reported in another study, people who have their cataracts removed and replaced with implants have half the car accident risk of people who don’t have surgery,” cites Dr. Daniel Ferguson, an ophthalmologist who cares for patients of all ages and walks of life at offices in West Allis, Milwaukee and Wauwatosa.

04

“Improve your vision, and you’ll decrease your risk of falling by up to 78 percent, according to a study from Israel,” notes Dr. Mark Freedman, an eye care

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Affordable Apartment Homes

for Seniors 55 and better

*Rents starting at $550 * Spacious 1 & 2 Bedroom * Apartment Homes * New Resource Room * Beautifully Decorated * Community Rooms * Intercom Entries & Elevators * Same Floor Storage & Laundry * Walking Distance to Shopping, * Parks, and Restaurants * Catered Lunches

Willamstown Bay Senior Apartments

3400 East Ramsey Avenue (414) 481-8580 Professionally Managed by Oakbrook Corporation 46 MHL HEALTHWISC JUNE 2011

EQUAL HOUSING OPPORTUNITY

specialist with thousands of cases under his surgical cap. Of the nearly 1,000 hip fractures that occur in the U.S. each day, 18% are caused by visual impairment. And, when falls lead to hip fractures: (only) 25% of patients make a full recovery, 50% subsequently need a cane or walker, 40% require nursing home care, and 24% of those over age 50 will die within 12 months due to complications.

Redefining Assisted Living

TR

05

Act now. Maintaining good vision is an investment for your future. Vision loss can take physical, psychological and financial tolls, including: inability to carry out normal daily tasks (hygiene, cleaning, reading, etc.), increased risk of injury and accidents, nutritional deprivation (can’t see to shop or prepare food), enhanced disabilities (other problems become worse as it is more difficult to take medications, exercise, etc.), social problems (withdrawal, depression, isolation, anger, fear), and loss of freedom (inability to work, drive, shop, do hobbies, etc.). “Scheduling regular eye check-ups today can help avoid these costs and suffering for tomorrow. And, if your symptoms and exam results meet the proper criteria, most insurances, Medicare and Medicaid will often pay for a majority of your treatment,� says Dr. Brett Rhode, Head of Ophthalmology at Aurora Sinai Medical Center and a partner at Eye Care Specialists. “And, at our offices, if you don’t have insurance, we can usually arrange a payment plan.�

06

Taking care of your vision may prevent needless suffering and loss of independence. For example, a Japanese study noted that cataract treatment significantly improved functioning in people previously diagnosed with cognitive impairment. “Cataract removal is sometimes seen as working miraculous cures on elderly patients mislabeled as confused, depressed or having dementia. Often, these people weren’t in need of a ‘miracle,’ institutionalization or other drastic measures. The problem was just that they couldn’t see well,� explains Dr. Robert Sucher, a state leader in cataract surgery techniques and technology.

07

Many conditions (like glaucoma) may not offer early warning signs or are masked by the healthy eye’s ability to compensate. The only way to definitively know if you have an eye disease is to schedule a comprehensive dilated eye exam every two years, especially after age 40. If you don’t, undiagnosed and untreated conditions (like AMD, cataracts and diabetes) may slowly be stealing your vision without you realizing it.

TODAY. TOMORROW. TOGETHER. (414) 258-1814 Retirement Living, Home Care, Skilled Nursing, Rehabilitation Services, Hospice 10101 W. Wisconsin Ave. Â? Wauwatosa, WI 53226 www.stcam.com

Free Booklets & Opportunity to Ask Questions The physicians quoted above are partners at Eye Care Specialists, SC., a leading ophthalmology practice that provides medical, surgical and laser care to more than 121,000 Wisconsinites. They are dedicated to the diagnosis and treatment of cataracts, glaucoma, diabetic eye disease, and macular degeneration; and have written their own series of booklets on these conditions. Call 414-321-7035 for FREE copies or to schedule an appointment for a thorough eye screening (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National Avenue. They also offer eye care information at www.eyecarespecialists.net.

1st month

free!

<< EYE see page 6 to see when an eye doctor examines a patient. Sometimes patients will have cataract surgery and still notice that their vision is not clear because they have ABMD in their cornea. People who have this problem will usually not have a large improvement in vision with glasses, but will notice markedly improved vision when looking through a pinhole or after being fit with a rigid gas permeable contact lens. Treatment for ABMD largely depends on whether a person is experiencing recurrent erosions, blurry vision, or both. Treatments include using ointments at bedtime to prevent erosions from occurring in the morning, and taking mild topical steroids with oral medications. Treatment may also involve gentle surgical removal of the corneal surface or laser surgery to remove abnormal deposits. Special instruments can be used to help create a better bond between the new cells that grow on the surface of the cornea and the layers beneath them. Deciding on the best treatment largely depends on the amount of disease a patient has, the frequency of symptoms, and how aggressively a patient wants to pursue a cure (i.e. treatment ranges from topical medications to surgery). This is best determined by seeing your ophthalmologist and following up with them when you have symptoms.

* *

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22 HEALTHWISC JANUARY 2011

JUNE 2011 HEALTHWISC MHL 47

Pe to be

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Registration Now Open

2011 Wisconsin Senior Olympics

The Wisconsin Senior Olympics registration begins June 1 and extends through September 2. The games will be held September 2 - 19 in locations across the Milwaukee area. Online registration is available or registration forms can be download at www.wisenriorolympics.com. Registration forms will also be mailed to those who request them by calling (262) 424-2149. The 2010 Wisconsin Senior Olympics were very successful with over 800 participants. Participants were able to compete and qualify for the 2011 National Senior Games to be held in Houston, TX. This year’s Wisconsin Senior Olympic games are expected to draw even more senior athletes who seek to compete in over 20 different sporting events. This year’s games will feature: swimming, bowling, volleyball, track and field, pickleball, race walk, tennis, horseshoes, table tennis, softball, 5K road race, cycling, golf, power walk, shuffleboard, badminton, basketball, basketball free throw, lawn bowling, powerlifting, archery, triathlon and racquetball. The

Enriching Lives www.

Club

games are open to anyone who is 55 or older. Wisconsin Senior Olympic games are open to anyone regardless if you live in the state of Wisconsin. The Wisconsin Senior Olympics Opening Ceremonies will kickoff of the games and will be held on Tuesday, September 7. The Wisconsin Senior Olympics has a mission to provide Wisconsin’s older adults the opportunity to maintain and improve their overall fitness and wellness, through recreational, social and competitive events. The Senior Olympics encourages older adults to stay active, and gives them a reason to renew past skills or learn new ones. Key goals are to: maintain and improve the health and wellness of Wisconsin’s seniors, provide a competitive athletic, recreational and creative experience and to provide an opportunity for socialization for seniors from across the state. The Wisconsin Senior Olympics office is located at 125 North Executive Drive, Suite 207, Brookfield, WI 53005. You can contact them at (262) 4242149 or at www.wiseniorolympics.com.

A Free Club Designed Just For You! Al e x i a n . c o m

call (414) 357-5105, ext. 5851 for more information and to join Club Alexian! It’s Free!

Club

Alexian is a vibrant community program designed exclusively for adults aged 55 or older. Club Alexian offers a variety of programming, events and partner discounts promoting a healthier and vibrant living. Take advantage of trips and wellness opportunities. NO MEMBERSHIP FEE

Show your

Club Alexian.com or call (414) 357-5105, extension 5851

Club Alexian card at these partner locations and receive great discounts!

Marcus Theatre 11700 N. Port Washington Road Mequon, WI 53092 MC Access – Enjoy discounts on Broadway Shows in Milwaukee YMCA: Rite Hite Family Receive 50% off registration fees for new members 9250 North Green Bay Road, Brown Deer Zaffiro’s Pizzeria and Bar Exclusive North Shore location Receive 15% off your dine-in order purchase. 1700 N. Port Washington Road, Mequon Applebee’s Receive 10% off your entire food purchase Monday – Friday, 11:00 a.m. – 5:00 p.m. Living Well Day Spa Receive 10% off any Living Well Day Spa Service Alexian Village, 9301 N. 76th Street “Fit For Life” Fitness Program Receive 25% off the first three months.

48 MHL HEALTHWISC JUNE 2011

Join at www.

Alexian Village, 9301 N. 76th Street Realtor Executives Free staging consultation with a professional stager while you sell your home. This is a $150 value. Bruce Nemovitz, Milwaukee Chiropractic Company 10% discount on massage & nutrition supplements 9001 N. 76th Street, Suite 104, Milwaukee, WI 53223 The Flower Source Receive 15% off your purchase W156N11124 Pilgrim Road, Germantown, WI 53022 Universal Transportation Systems Receive 10% discount for Limo Services and Moving Services New Port Shores Restaurant Buy one Sunday Brunch and receive the second of equal or lesser value free! 407 E. Jackson Street, Port Washington

The Chocolate Chisel Receive 10% off your purchase 125 W. Grand Avenue, Port Washington Fireworks Popcorn Receive 10% off your purchase 101 W. Grand Avenue, Port Washington Harborview Cleaners Receive 20% off cleaning of Quilts, Bedspreads and Comforters, 134 E. Grand Avenue, Port Washington Heart of Grafton, Family Restaurant Receive 10% off your purchase 305 Wisconsin Avenue, Grafton Bloomin Olive Receive 10% off your purchase 1404 12th Avenue, Downtown Grafton Sweettrio Receive 10% off your purchase 1225 Washington Street, Grafton

HEALTHY AGING TIPS HOW TO FEEL YOUNG AND LIVE LIFE TO THE FULLEST

Healthy aging is about much more than staying physically healthy—it’s about maintaining your sense of purpose and your zest for life.

As we grow older, we experience an increasing number of major life changes, including retirement, the loss of loved ones, and the physical changes of aging. How we handle these changes, as well as regular day-to-day stresses, is the key to aging well. Healthy aging is about much more than staying physically healthy—it’s about maintaining your sense of purpose and your zest for life. While the specific ingredients of healthy aging are different for everyone, the common factors are good mental health and the ability to manage stress. Knowing the basic formula for healthy aging will help you live with meaning and joy throughout your senior years. Finding and following your formula for healthy aging Coping with change is difficult, no matter how old you are. The particular challenge for older adults is the sheer number of changes and transitions—including the loss of friends, family, your career, your health, and even your independence. It’s natural to feel those losses. But if that sense of loss is balanced with positive ingredients, you have a formula for aging well. Healthy aging means continually reinventing yourself, finding new things you enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones. Unfortunately, for many, aging brings anxiety and fear instead. How will I take care of myself? What if I lose my spouse? What is going to happen to my mind? However, many of these fears stem from myths about aging that are exaggerated or simply untrue. The truth is that you are stronger and more resilient than you may think. Myths About Healthy Aging MYTH: Old age means poor health and disability. Fact: There are some diseases that are more common in older adults. However, getting old does not automatically mean poor health or that you will be confined to a walker or wheelchair. Plenty of older adults enjoy vigorous health. Preventive measures like healthy eating, exercising and managing stress can help reduce the risk of chronic disease and fall risk later in life. >> AGING see page 50

Remember when friends were neighbors and neighbors were friends …

… when folks popped by just to say hello?

Well, that’s exactly the sense of community you’ll find at Luther Manor. With charming studio apartments, spacious two-bedroom models and everything in between, all you would expect from a caring, faithful community can be found right here – a variety of social opportunities, a bank, a corner market and even an ice cream parlor. And, should you want or need assistance with housekeeping, meal preparation, medication management or personal care, an array of Supportive Services is available to help you remain safe and comfortable in your new home.

Come see for yourself. For more information or to schedule a tour, call (414) 464-3880.

LUTHER M ANOR

Senior Living Community JUNE 2011 HEALTHWISC MHL 49

Exceptional Living... .. Exceptional People

<< AGING see page 49 MYTH: Memory loss is an inevitable part of aging. Fact: You may eventually notice you don’t remember experiences as easily as in the past, and memories may take longer to retrieve. However, significant memory loss is not an inevitable result of aging. Brain training and new learning can occur at any age. And there are many things you can do to keep your memory sharp.

ALLIS

Care Center

EQUAL HOUSING

9047 W. Greenfield Ave. West Allis, Wisconsin 53214 Phone: (414) 453-9290 Fax: (414) 777-7356

OPPORTUNITY

Respite Stays Skilled Nursing Services Alzheimer’s/Dementia Care Physical, Occupational, and Speech Therapy Services www.exceptionallivingcenters.com

Affordable

Senior Housing River Park I & II

1600-1700 east River Park Court Shorewood, WI 53211 414-961-1696

Willow Park Apartments 1001 Delafield St. Waukesha, WI 53188 262-548-9786

Amentities

1 Bedroom Apartments Electricity Included Stove & Refrigerator provided Community/Social Rooms Off street Parking Laundry Rooms Library & Beauty Shop on site Handicapped Accessible Buildings Educational & Fun Activities (Income Restrictions Apply)

MYTH: You can’t teach an old dog new tricks. Fact: One of the more damaging myths of aging is that after a certain age, you just won’t be able to try anything new or contribute things anymore. Quite the contrary. Older adults are just as capable of learning new things, thriving in new environments, and sharing their wisdom and experience with many generations. If you believe in yourself and have confidence in yourself, you are setting up a positive environment for change no matter what your age. Healthy aging: Tips for coping with change As you age, there will be periods of both joy and stress. It’s important to build your resilience and find healthy ways to cope with challenges. This ability will help you make the most of the good times and keep your perspective when times are tough. Focus on the things you’re grateful for. The longer you live, the more you lose. But as you lose people and things, life becomes even more precious. When you stop taking things for granted, you appreciate and enjoy what you have even more. Acknowledge and express your feelings. You may have a hard time showing strong emotions, perhaps feeling that such a display is inappropriate and weak. But burying your feelings can lead to anger, resentment, and depression. Don’t deny what you’re going through. Find healthy ways to process your feelings, perhaps by talking with a close friend or writing in a journal. Accept the things you can’t change. Many things in life are beyond our control. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems. Face your limitations with dignity and a healthy dose of humor. Look for the silver lining. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes. Take daily action to deal with life’s challenges. When challenges seem too big to handle, sweeping them under the carpet often appears easier. But ignoring the problem doesn’t make it go away; it allows both the problem and your anxiety to build. Instead, take things one small step at a time. Even a small step can go a long way to boosting your confidence and reminding you that you are not powerless. Reprinted with permission from Helpguide.org © 2001-2010. All rights reserved. For more articles in this series, visit www.Helpguide.org.

Professionally managed by Ogden & Company

NO ONE CAN OFFER BETTER PEDORTHIC CARE ! QUALITY...INNOVATION...EXPERIENCE... FOR MORE THAN 40 YEARS, NPS HAS BEEN DEDICATED TO PROVIDING THE HIGHEST QUALITY PRESCRIPTION FOOTWEAR FOR YOU AND YOUR PATIENTS. Chronic Disease—Diabetes Congenital Conditions Cerebral Palsey Rehabilitation Work Injury Trauma

SERVICES INCLUDE: COMFORT SHOE ATHLETIC FOOTWEAR FOOT ORTHOTICS BRACES

NATIONAL PEDORTHIC SERVICES, INC.

Chronic Disease—Arthritis Muscular Sclerosis Sports Injuries Overuse Stroke Aging

MILWAUKEE AREA - 7283 W. APPLETON AVE. TEL: (414)438-1211 / 2745 W. LAYTON AVE. TEL: (414)282-8888 PEWAUKEE - 325 FOREST GROVE DR. TEL: (262)691-9490 MADISON - 1825 S. PARK STREET TEL: (608)225-3500 FOND DU LAC - 885 WESTERN AVE TEL: (920)907-1060 50 MHL HEALTHWISC JUNE 2011

THE

independent

RETIREMENT COMMUNITY LIFESTYLE

Independent Retirement Communities increase socialization and offer the opportunity to make new friends! Independent Retirement Communities are for active adults who want to live life to the fullest. Community living provides the opportunity to enjoy maintenance free living, financial security, fitness programs, healthy dining, socialization and educational sessions. Mowing the grass, shoveling the snow, repairing the kitchen faucet or paying real estate taxes can become a thing of the past. Before you can make a decision it is important to understand what senior community life is all about. Some seniors have been misinformed and believe that Independent Retirement Communities are for “old folks” who belong in nursing homes, or need daily care. This is certainly not true. Independent Retirement Communities offer the best in senior living options and keep seniors young at heart. Research shows that the more active and social you are, the longer you live, and the healthier you remain. Independent Retirement Communities are more affordable than you ever imagined! If you add up the cost of annual repair and maintenance on your home, along with taxes, lawn care costs, utilities, etc, you might find that living in an Independent Retirement Community is the same cost or less! Retirement communities offer wide range of amenities to enhance your lifestyle. Indoor/outdoor swimming pools, recreation centers, exercise rooms, libraries, craft rooms, laundry services,

housekeeping, and transportation are all possible options. On campus restaurant style dining, cafés and bistros can take the work out of meal preparation as well as offer a chance to dine with friends. Independent Retirement Communities increase socialization and offer the opportunity to make new friends! From the moment you arrive, the sense of community and togetherness is apparent. Although there is plenty of time for relaxation in your own apartment there are also many activities designed to bring residents together - women’s groups, men’s groups, bridge clubs, fitness groups, craft classes, book discussion groups, and many more options…you name it, it’s probably available! Another benefit is transportation. Some seniors enjoy driving for many years, and others prefer not to drive especially during inclement weather. Either way, you will feel right at home using your own car or enjoying the luxury of door to door service. Transportation to the grocery store, doctor appointments, and local shopping malls is available. Adult children feel great about their parents choice to live in an Independent Retirement Community. They love knowing that if anything happens, help is not far away. The fact that so many people are looking out for their parents safety and health gives great peace of mind. The level of activity and sense of community is

second to none. A Continuing Care Retirement Community (CCRC) like Tudor Oaks offers multiple levels of care. This type of retirement community gives active seniors the ability to enjoy an independent lifestyle with the knowledge that all of their needs will be met should their health care situation change. A Senior Apartment Complex offers senior apartments with few if any amenities. Seniors in this community will need to move again if their needs change. It is interesting to note that the monthly rent over a period of time could use the saved funds that would have allowed the senior to enter a CCRC and have a continuum of care available. Choosing the correct senior living community ensures that you or your loved one will have every opportunity to fully enjoy retirement, amidst a community of peers, with a full-range of activities in a safe environment. One of the most important things you can do when considering your retirement years is to plan ahead. Addressing financial and health issues early keeps families from having to deal with a crisis later. Current residents of Tudor Oaks and other Independent Retirement Communities will tell you the same thing over and over again. “I should have done this many years ago, it was the best decision I ever made!”

JUNE 2011 HEALTHWISC MHL 51

grandparenting tips Building Great Relationships with your Grandkids

www.modernhealthandliving.com

52 MHL HEALTHWISC JUNE 2011

As grandparents we all want to make the most of the precious family time we get to spend with our grandchildren. The best grandparenting activities flow from the interests of both the grandparents and the grandchildren. You can create deep, loving relationships with your grandchildren by sharing the things you love with them, and by learning about what excite them. Whether you’re a full-time grandparent, a step-grandparent, or a long distance grandparent living thousands of miles away, you can find new ways to strengthen family ties and provide your grandchildren with joyful memories and valuable life lessons. What’s so grand about grandparenting? In no particular order, grandparenting is an opportunity to play, to love someone new, to appreciate the magic of a developing mind, and to be needed by someone again. Grandparents can: Share the things they’re passionate about with a new audience. See the world in a new way through younger eyes. Experience games, music, nature, reading, and other interests in conjunction with a curious young mind. Provide expanded support and encouragement to their grandchildren. Use their breadth of experience to avoid the pitfalls they may have encountered as parents the first time around. Watch children develop through all stages of growth. Learn about their grandkids’ music and passions. Provide input that parents cannot. Usually, grandparents have the benefit of interacting on a level that is once removed from the day-to-day responsibilities of parents. This can make it easier to develop a close bond with grandchildren. From near or far, grandparenting can provide continuity in a child’s life. Grandparents are often the family historians, and can add a rich sense of family tradition to a child’s life. Additionally, contact with grandparents can teach children positive attitudes towards aging and help them develop skills to enhance their own lifelong learning. Of course, not everything about being a grandparent is great all of the time. Becoming a grandparent at a young age can make some people feel prematurely old and, just as parents do, grandparents sometimes have to deal with colicky babies and moody teenagers. For most though, the benefits of being a grandparent far outweigh the drawbacks. The role of a grandparent in a child’s life There are as many answers to this question as there are different family configurations and needs. Some grandparenting requires a full-time commitment. For others, grandparenting is a weekend together, an afternoon play date, a summer vacation, a chat on the phone, or an email exchange every now and then. A good first step to a long and successful relationship with your grandchild is to establish some ground rules with your son or daughter: Be clear about what role you want to have in your grandchild’s life. How often you want to babysit, for example, or whether you’d like to be included in events such as school functions. Talk with parents about their rules. Consistency is important for kids, so know the behavior limits your grandchild has to follow at home and maintain the rules when

The best grandparenting activities flow naturally from the interests of both the grandparents and the grandchildren.

he or she is with you. Enforce any agreed upon punishment for bad behavior, whether it’s a “time out” or loss of privileges, for example. Babyproof your home, to ensure safety for infants and toddlers. It’s probably been a number of years since you had young children in your home so it’s important to check with your grandchild’s parents about ways to babyproof your home, so they’re comfortable leaving the child with you. Common grandparenting pitfalls to avoid Whatever your specific circumstances, when you are expressing love, showing concern for your grandchild’s safety and wellbeing, and being consistent in your behavior, you are probably already doing an excellent job of grandparenting. To avoid potential conflict within your family, try to avoid these common grandparenting pitfalls: Trying to be the parent. As much as you might want to tell your children how to raise your grandkids, it’s not your role. Respect the parenting decisions your children make for your grandkids. Buying your grandkids’ affection. It’s tempting for grandparents to shower their grandkids with gifts, but check with the child’s parents before you buy more toys. Maybe substitute some of your gift giving with activities instead. Do something with your grandchild that you both love and will build memories. Shower them with love instead of gifts. Overindulging the first few grandchildren and then not being able to repeat it as additional grandchildren come along. This can cause resentment from your own children who have kids later in life. Remember that whatever you do for your first grandchild (college fund, beach vacations, trips to the zoo) will set a precedent that you’ll need to repeat for every other grandchild. Ignoring boundaries. A grandparent who won’t enforce limits and gives in to their grandchild’s every whim can infuriate parents. By allowing your grandkids to misbehave, overindulge in candy and junk food, or ignore bedtimes, for example, you’re only encouraging unhealthy behavior and making their parents’ job even harder. Tips for spending quality time with your grandkids The best grandparenting activities flow naturally from the interests of both the grandparents and the grandchildren. You can create a deep, loving relationship with your grandchildren by sharing the things you love with them, and by being available to hear about the ideas and activities that excite them. Take it easy together Make an effort to enjoy leisure time with your grandchildren. As a grandparent, you get to interact with your grandchildren without the same daily pressures of a parent—you don’t have to worry about driving carpool or juggling making dinner for the family with soccer practice and grocery shopping. Allow yourself to slow down and become really absorbed in an activity. Moving at a slower pace than usual can give children a sense that time can be ‘stretched’—that you don’t need to hurry through activities. And, as with adults, it gives them the psychic space to feel, reflect, and express emotions without feeling rushed. Go outside Children love the outdoors, and trips to the park or the beach can be a great jumping off point for some wonderful adventures and happy memories. Nature walks and day hikes can provide lots of interesting things to talk about, and water activities can be especially fun. Throwing stones into the water or watching the current play with sticks are simple activities that can be fascinating to children. You can start these activities when kids are toddlers, and expand the games as they get older. Share your interests or your work Engaging in hobbies and activities that you love or your grandchild loves can be a great way to spend time together and learn about each other. Sometimes, activities that you might not expect your grandchildren to be interested in, like knitting or gardening, might turn out to provide an important point of connection for you. Similarly, if you take an interest in something they are passionate about, like trading cards or the Harry Potter books, they get to share their special area of knowledge and may open up in new ways. If you are still working, a visit to your place of work can add a dimension to your grandchild’s perception of you. If you are retired, pictures and stories about what your working days were like can do the same. Reprinted with permission from Helpguide.org © 2001-2010. All rights reserved. For more articles in this series, visit www.Helpguide.org.

PROFESSIONAL CARE WITH A PERSONAL TOUCH An affordable alternative serving the special needs of the elderly community. Our elderly living facilities provide a comfortable and charming homelike atmosphere.

Our Amenities Include: 24-Hour Service Staff 3 Meals Daily Housekeeping Services Assistance with Medications

Daily Activity Programming Peace of Mind of Resident & Family Private Accommodations Linen/Laundry Service

Nursing Services Personal Care Assistance Special Events, Tours, Trips R.N. Owner Operated

ST. JOHN’S MANOR

ST. MARY’S MANOR

812 Marquette Avenue South Milwaukee 762-2511

1313 Missouri Avenue South Milwaukee 762-8026

email: ellen@clcel.com

website: www.stjohns-marysmanors.com

TODAY. TOMORROW. TOGETHER. Imagine a carefree retirement lifestyle... Picture yourself in a beautifully appointed apartment with social, educational and cultural activities.

Come and sample life and lunch at

Monday June 13th, 2011 Space is limited call (414) 259-6310

www.stcam.com JUNE 2011 HEALTHWISC MHL 53

<< TEA see page 19 being diagnosed with prostate cancer than those who drank the least. But for men with—or at high risk of—prostate cancer, tea may make a difference, says Henning. “I would definitely advise then to drink large amounts of green tea, because it may slow down the progression of the disease.” Only one of the four studies in Japanese and Hawaiian men looked at the risk of advanced prostate cancer separately. It found that those who drank five or more cups of green tea a day had half the risk of those who drank less than one cup a day. Then there’s a 2006 Italian study “whose results were remarkable,” says Hasan Mukhtar, a professor of cancer research at the University of Wisconsin in Madison. Researchers recruited 60 men with high-grade prostate intraepithelial neoplasia (PIN) lesions, some of which turn into prostate cancer. Half the men were given 600 milligrams a day of a green tea extract and half were given a placebo. After one year, 10 of men had been diagnosed with prostate cancer. Nine were in the placebo group. Only one had been taking the green tea extract. “It was a nice study, but it was pretty small,” says tea researcher Joshua Lambert of Pennsylvania State University. “It needs to be confirmed by larger intervention studies.” Several trials are in the works. Five years ago, UCLA’s Henning started giving men who were awaiting surgery to remove their cancerous prostate five cups of green tea, black tea, or water every day. She’s looking at whether the tea has any impact on their PSA levels or on the cancer cells in their prostate. (PSA levels may reflect the growth of prostate cancer.) And in 2007, researchers at the Moffitt Cancer Center and Research Institute in Tampa, Florida, began giving green tea extracts to men with high-grade PIN lesions. They expect to complete their study by the end of 2012. BREAST CANCER “Cohort studies that follow women for years really do not show any protective effect from drinking tea on the risk of developing breast cancer,” says Anna Wu, co-leader of the Cancer Control Research Program at the University of Southern California’s Keck School of Medicine in Los Angeles. In the six studies that tracked more than 140,000 women in Japan, Sweden, the Netherlands, and the United States for up to 24 years, those who reported drinking the most tea were no less likely to be diagnosed with breast cancer than those who drank the least tea. But green tea may make a difference in women who already have breast cancer. In two studies of Japanese women who had been diagnosed with breast cancer,

iÊ >ÀiÊUÊ °6°Ê >ÀiÊUÊ Ã« ViÊ >Ài iÊ >ÀiÊUÊ °6°Ê >ÀiÊUÊ Ã« ViÊ >Ài We care not only for the mind, body and spirit patients likefor Steve, but of body their and family We of care not only the mind, andofloved ones,likelikeSteve, his daughter Linda. spirit patients but of their family Contact us ones, anytime, your physician and loved like or hisask daughter Linda. for a no-obligation referral. Contact us anytime, or ask your physician for a no-obligation referral. 977/327/6819!!¦!!www.heartlandhospice.com 977/327/6819!!¦!!www.heartlandhospice.com 54 MHL HEALTHWISC JUNE 2011

those who drank more than three cups of green tea every day had a 27% lower risk of having their cancer recur than those who drank little or no green tea. That’s far from proof, though. “The problem in interpreting studies like these is that drinking green tea is an indicator of an Asian lifestyle, including lower body weight, more physical activity, and more soy in the diet,” points out Regina Ziegler, a researcher at the U.S. National Cancer Institute (and a member of Nutrition Action’s Scientific Advisory Board). “So it could be that this lifestyle, rather than drinking green tea, helped protect these women from getting breast cancer again.” METABOLISM Eight O’Clock Metabolism Boost Performance Blend coffee beans are “gently infused” with 40 to 70 milligrams of EGCG per brewed cup, “to naturally enhance the body’s own metabolism.” GNC’s “be-ENERGIZED Calorie Burning Formula” (“Burning calories has never been so easy”) supplements its 200 mg of caffeine with 25 mg of EGCG, “to boost your metabolism.” Does EGCG make you burn more calories? “If you test the tea polyphenols like EGCG alone, you don’t see that they have very much of an effect on metabolism,” says researcher Mario Ferruzzi of Purdue University in West Lafayette, Indiana. They don’t appear to do much for weight either. A recent meta-analysis found that overweight men and women who consumed 282 mg of EGCG every day weighed no less after 12 weeks than similar people who took a placebo. “If you combine tea polyphenols with caffeine, you do see a bump in shortterm energy expenditure compared to people taking just caffeine or a placebo,” notes Ferruzzi. “Whether that helps you maintain a healthy weight is a whole other issue.” (Ferruzzi is a co-patent holder for a weight-maintenance drink that contains tea and caffeine and that was the basis for Coca-Cola’s Enviga drink.) In the meta-analysis, the mix of EGCG and caffeine wasn’t very impressive. After three months of taking polyphenols plus caffeine every day, overweight men and women—some were dieting and some weren’t—lost an average of just one more pound than similar people who took a placebo. “Small and not likely clinically relevant,” was the way the researchers summed up their results. MEMORY “Regular tea drinkers may experience a different rate of cognitive decline than non-tea drinkers,” says UCLA epidemiologist Lenore Arab. Arab and her colleagues analyzed data from the Cardiovascular Health Study, which has been tracking heart disease and stroke rates in adults 65 years of age and older in North Carolina, California, Maryland, and Pennsylvania since 1989. More than 4,800 of the study participants took a yearly Mini-Mental State Examination (MMSE)—a questionnaire that is used to screen for memory loss and other cognitive impairment. Those who drank tea—green or black—at least five times a week had about a 30% slower rate of decline in their scores than those who didn’t drink tea at all. But so did those who drank tea just one to three times a month. So it’s not clear whether tea, rather than something else about tea drinkers, protects the brain. The results, which were presented at an Alzheimer’s disease conference last summer, haven’t yet been published. An earlier long-term study among older Chinese adults living in Singapore also found that tea drinkers had a slower rate of cognitive decline than non-tea drinkers. Arab’s bottom line: “We are still very early in the game. We’re not there yet in terms of saying anything that’s definitive.” Copyright 2011 SPI, Reprinted/Adapted from Nutrition Action Healthletter, 1875 Connecticut Ave., N.W., Suite 300, Washington, D.C. 20009-5728.

<< HINTS see page 39 standing up. •Watch out for the wires and tubes that may be around your bed. •Try to keep the things you need within easy reach. •Only take medicines given to you by nurses. Don’t take medicine you brought from home without your doctor’s permission. •Hold on to grab bars for support when getting in and out of the bathtub or shower and when using the toilet. GERIATRIC EVALUATION Older people may have health problems that make it hard for them to live on their own after they leave the hospital. In some hospitals, a team that includes a doctor, nurse, and social worker takes care of the special needs of older patients. This team also may include other specialists and therapists. The team performs a careful exam, called a geriatric assessment, to learn about the patient’s physical and mental health, family life, income, living arrangements, access to community services, and ability to perform daily tasks. The team checks for health problems and makes a plan to help older patients get the health care and social services they need after they go home. FOR FAMILY AND CAREGIVERS A hospital stay can be very hard for older people. Often the strange routine and lack of sleep can cause confusion. Family and caregivers may be the first to notice these changes. Families should talk to a doctor if they see any confusion. ASK QUESTIONS During your hospital stay, you may have questions about what’s happening. You may want to ask your doctor or nurse: •What will this test tell you? Why is it needed and when will you know the results? •What treatment is needed and how long will it last? •What are the benefits and risks of treatment? •When can I go home? •When I go home, will I have to change my regular activities or my diet? •How often will I need checkups? •Is any other follow-up needed? •Who should I call if I have other questions? Patient Rights Before you go to the hospital, you might want to think about writing an advance directive. An advance directive says what medical treatment you want if you can’t speak for yourself. It also lets you name who you want to make your medical decisions. Two common kinds of advance directives are: •living will •durable power of attorney for health care In a living will, you list the kind of medical care you want (or don’t want); it’s called a living will because it takes effect while you are still alive. In a durable power of attorney for health care, you name someone else (a family member or friend, for example) to make your medical decisions if you are unable to make them for yourself. You also can list any treatment you don’t want. If you have an advance directive, bring a copy of it with you to the hospital. Make sure your doctor has a copy and check to make sure your wishes are part of your medical records. If you have a durable power of attorney for health care, be sure to give a copy to the person you’ve chosen to act on your behalf. GOING HOME When you are ready to go home, you’ll get discharge plans from the medical team and a release form from the hospital business office. Sometimes people go from the hospital to a rehabilitation (rehab) center before going home. The social worker can help you go home or arrange admission to a rehab center.

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